Premium
Vaginal Microbiota, Racial/Ethnic Groups, and Risk of Preterm Birth
Author(s) -
Foxman Betsy
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.368.1
Subject(s) - bacterial vaginosis , carriage , ethnic group , subclinical infection , medicine , demography , obstetrics , pathology , sociology , anthropology
Premature birth (PTB) is a major cause of infant mortality. Infection, both overt and subclinical, accounts for ~25‐40% of all PTBs. When the composition of vaginal microbiota is perturbed, as occurs during bacterial vaginosis (BV), there is an increased risk of PTB. However, the effects of BV treatment on reducing PTB rates have been disappointing, even resulting in an increased risk of PTB in some groups. BV prevalence varies by racial/ethnic group being highest among Black Americans ‐ as is risk of PTB. I discuss the variations in and interactions among taxa in the vaginal microbiota by racial/ethnic group, and review the growing literature suggesting that some of the increased risk of preterm birth among Black Americans is attributable to differences in immune response to specific vaginal bacteria, rather than differences in carriage rates. Further, I present evidence that the associations of specific microbes with PTB are contingent of the presence of co‐factors, not only host behaviors, but the other members of the microbial community and the overall host response to that community.