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Preterm birth: associations with genital and possibly oral microflora
1Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA. gbh@acpub.duke.edu
Annals of Periodontology
|September 2, 1998
Summary
Opportunistic microbes in bacterial vaginosis (BV) increase risks for preterm birth (PTB). Oral pathogens from periodontal disease may also contribute to PTB through an oral-hematogenous route.
Area of Science:
- Microbiology
- Obstetrics
- Periodontology
Background:
- Opportunistic pathogens in the female genital tract are linked to pelvic infections and preterm birth (PTB).
- Bacterial vaginosis (BV) involves an overgrowth of specific microbes (e.g., Gardnerella vaginalis, anaerobes) replacing normal lactobacilli.
- The BV microbial complex is associated with increased risks of preterm labor, premature rupture of membranes, and PTB.
Purpose of the Study:
- To explore the role of genital tract opportunistic pathogens and oral pathogens in preterm birth.
- To investigate the pathogenetic mechanisms linking microbial imbalances and periodontal disease to PTB.
Main Methods:
- Review of existing literature on microbial etiologies of PTB.
- Analysis of microbial profiles in vaginal secretions and amniotic fluid.
- Comparison of oral and genital tract microbial strains.
Main Results:
- BV-associated microbes significantly increase risks for PTB and other perinatal infections.
- Fusobacterium nucleatum, an oral species, is frequently isolated from amniotic fluid in preterm labor cases.
- Oral fusobacteria strains isolated from amniotic fluid match those found in periodontal disease sites.
Conclusions:
- Genital tract infections and BV are significant risk factors for PTB.
- Periodontal disease and oral pathogens represent a potential, understudied route to PTB via hematogenous spread.
- Further research is needed to elucidate the oral-hematogenous pathway to PTB.