BV-associated bacteria and adverse pregnancy outcomes among urban women

城市女性 BV 相关细菌与不良妊娠结局

• 批准号: 8061641
• 负责人: Deborah B Nelson
• 金额: $ 45.39万
• 依托单位: TEMPLE UNIV OF THE COMMONWEALTH
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-06-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8061641
• 关键词: Affect; Anaerobic Bacteria; Atopobium vaginae; Bacteria; Bacterial Vaginosis; Biological Assay; Birth; Characteristics; Chronic; Cohort Analysis; Cohort Studies; Complex; Data Collection; Death Rate; Effectiveness; Enrollment; Epidemiology; First Pregnancy Trimester; Gardnerella vaginalis; Genes; Genotype; Gram' s stain; Health; High Risk Woman; Infant; Inflammatory; Interview; Leptothrix; Leptotrichia; Link; Measurement; Measures; Metronidazole; Mobiluncus curtisii; Morbidity - disease rate; Persons; Population; Pregnancy; Pregnancy Outcome; Pregnant Women; Premature Birth; Prenatal care; Public Health; Recruitment Activity; Risk; Role; Sampling; Structure; Swab; Syndrome; Time; Universities; Vagina; Variant; Visit; Woman; Women' s Group; base; birth control; high risk; infant death; interest; mortality; pathogen; prospective; rRNA Genes; routine Bacterial stain

DESCRIPTION (provided by applicant): Spontaneous preterm birth (SPTB) affects more that 12 percent of all births among urban women and contributes to more than one-third of all infant deaths. Numerous adverse pregnancy outcomes have been prospectively linked to BV including SPTB. Despite the consistently strong epidemiologic link between BV and SPTB, many BV positive pregnant women deliver healthy, term infants and the current treatment options for BV are largely ineffective. Microbiologic variations exist among BV positive women and this variability may explain the limited effectiveness of metronidazole in curing BV and/or reducing SPTB risk. The aims of this amended, competing continuation application are: 1) to evaluate whether Gardnerella vaginalis, Mobiluncus curtisii, Atopobium vaginae, Leptotrichia amnionii, and the Clostridiales bacteria designated Bacterial Vaginosis-Associated Bacterium (BVAB) 1,2 or 3 measured in the first trimester of pregnancy are important, independent predictors of SPTB, and 2) to evaluate whether consistently high levels of Gardnerella vaginalis, Mobiluncus curtisii, Atopobium vaginae, Leptotrichia amnionii, and Bacterial Vaginosis-Associated Bacteria (BVAB) 1,2 or 3, measured at two points during pregnancy, are an important, independent predictor of SPTB. Women attending their first prenatal care visit at Temple University with a pregnancy of 12 weeks gestation or less will be recruited. Baseline data collection will be standardized and include a structured in- person interview, buccal swab for genotyping of three inflammatory genes, and vaginal swabs to detect the presence and degree of BV based on Gram stain. In addition, the concentrations of selected vaginal bacteria will be measured using PCR assays targeting 16S rRNA genes from the BV-associated bacteria of interest. Repeat vaginal swabs will be collected between18-20 weeks gestation to examine the change in these bacteria and the role of consistently high levels of BV-associated bacteria and SPTB risk. In this case-cohort study, we will enroll and classify 2200 pregnant women over a three year period and randomly sample 20 percent of the underlying population to generate the subcohort. We will identify all SPTB cases occurring within and outside the subcohort and compare the results to the remaining subcohort. Given the public health impact of high rates of infant morbidity and mortality due to SPTB, these results may identify a group of women at high risk of SPTB based on early pregnancy BV profile characteristics. These results will also examine the biologic mechanisms and co-factors most responsible for the increased risk of SPTB among urban, BV positive women and the ineffectiveness of current BV treatment options. PUBLIC HEALTH RELEVANCE: Spontaneous preterm birth (SPTB) affects more that 12 percent of all births and contributes to more than one-third of all infant deaths. Despite the consistently strong epidemiologic link between BV and SPTB, many BV positive pregnant women deliver healthy, term infants. The results from this study will add valuable information regarding the specific BV-associated bacteria most related to SPTB and may explain the current limited effectiveness of BV treatment in reducing the risk of SPTB.

描述（由申请人提供）：自发早产（SPTB）影响着城市妇女所有出生的12％，并贡献了所有婴儿死亡的三分之一以上。许多不良怀孕结果已与包括SPTB在内的BV有关。尽管BV与SPTB之间始终存在牢固的流行病学联系，但许多BV阳性孕妇提供健康的婴儿，而BV的当前治疗选择在很大程度上是无效的。 BV阳性女性存在微生物学变化，这种变异性可能解释了甲硝唑在治愈BV和/或降低SPTB风险中的有限效力。 The aims of this amended, competing continuation application are: 1) to evaluate whether Gardnerella vaginalis, Mobiluncus curtisii, Atopobium v​​aginae, Leptotrichia amnionii, and the Clostridiales bacteria designated Bacterial Vaginosis-Associated Bacterium (BVAB) 1,2 or 3 measured in the first trimester of pregnancy are important, independent predictors of SPTB, and 2) to评估始终高水平的gardnerella阴道，动物curtisii，Atopobium curtisii，leptritrichia amnionii和细菌性阴道病相关细菌（BVAB）1,2或3，在怀孕期间以两点测量，是SPTB的独立，独立的预测因子。招募了12周妊娠或更少的妊娠期，参加了在坦普尔大学第一次出现产前护理的妇女将被招募。基线数据收集将标准化，包括结构化的内部访谈，用于三个炎症基因基因分型的颊拭子以及阴道拭子，以检测基于革兰氏染色的BV的存在和程度。另外，将使用针对来自BV相关的感兴趣的细菌的16S rRNA基因的PCR分析来测量选定的阴道细菌的浓度。将在18-20周妊娠之间收集重复的阴道拭子，以检查这些细菌的变化以及始终高水平与BV相关的细菌和SPTB风险的作用。在这项病例研究的研究中，我们将在三年内注册和分类2200名孕妇，并随机对基础人群的20％进行样品以产生亚群。我们将确定子体内和外部发生的所有SPTB病例，并将结果与​​剩余的亚细胞比较。鉴于由于SPTB引起的高婴儿发病率和死亡率的公共卫生影响，这些结果可能会根据早期妊娠BV概况特征确定一群具有SPTB高风险的妇女。这些结果还将检查最大的生物学机制和联合因素，以使城市，BV阳性妇女的SPTB风险增加以及当前BV治疗方案的无效性。公共卫生相关性：自发性早产（SPTB）影响了所有出生的12％，并导致了所有婴儿死亡的三分之一以上。尽管BV与SPTB之间始终存在牢固的流行病学联系，但许多BV阳性孕妇提供了健康的年龄婴儿。这项研究的结果将添加有关与SPTB最相关的特定BV相关细菌的有价值的信息，并可以解释BV处理在降低SPTB风险中的当前有限效力。

项目成果

Associations between vaginal bacteria and levels of vaginal defensins in pregnant women.

• DOI: 10.1016/j.ajog.2012.11.019
• 发表时间: 2013-02
• 期刊: AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
• 影响因子: 9.8
• 作者: Mitchell, Caroline;Gottsch, Michelle L.;Liu, Congzhou;Fredricks, David N.;Nelson, Deborah B.
• 通讯作者: Nelson, Deborah B.

Role of perceived stress in the occurrence of preterm labor and preterm birth among urban women.

城市女性感知压力在早产和早产发生中的作用

• DOI: 10.1111/jmwh.12088
• 发表时间: 2014
• 期刊: Journal of midwifery & women's health
• 作者: Seravalli,Laura;Patterson,Freda;Nelson,DeborahB
• 通讯作者: Nelson,DeborahB

Determinants of excessive gestational weight gain in urban, low-income women.

城市低收入妇女妊娠期体重过度增加的决定因素。

• DOI: 10.1016/j.whi.2012.05.004
• 发表时间: 2012-09
• 期刊: Women's health issues : official publication of the Jacobs Institute of Women's Health
• 作者: Herring SJ;Nelson DB;Davey A;Klotz AA;Dibble LV;Oken E;Foster GD
• 通讯作者: Foster GD

Racial differences in bacterial vaginosis among pregnant women: the relationship between demographic and behavioral predictors and individual BV-related microorganism levels.

孕妇细菌性阴道病的种族差异：人口统计和行为预测因素与个体 BV 相关微生物水平之间的关系。

• DOI: 10.1007/s10995-008-0372-y
• 发表时间: 2009
• 期刊: Maternal and child health journal
• 影响因子: 2.3
• 作者: Uscher-Pines,Lori;Hanlon,AlexandraL;Nelson,DeborahB
• 通讯作者: Nelson,DeborahB

Objectively measured sleep duration and hyperglycemia in pregnancy.

• DOI: 10.1016/j.sleep.2013.07.018
• 发表时间: 2014-01
• 期刊: SLEEP MEDICINE
• 影响因子: 4.8
• 作者: Herring, Sharon J.;Nelson, Deborah B.;Pien, Grace W.;Homko, Carol;Goetzl, Laura M.;Davey, Adam;Foster, Gary D.
• 通讯作者: Foster, Gary D.