Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section

Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section: a prospective cohort study

Research output: Contribution to journal › Journal article › Research › peer-review

Standard

Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section : a prospective cohort study. / Haahr, Thor; Clausen, Tine Dalsgaard; Thorsen, Jonathan; Rasmussen, Morten A.; Mortensen, Martin S.; Lehtimäki, Jenni; Shah, Shiraz A.; Hjelmsø, Mathis H.; Bønnelykke, Klaus; Chawes, Bo L.; Vestergaard, Gisle; Jacobsson, Bo; Larsson, Per-Göran; Brix, Susanne; Sørensen, Søren J.; Bisgaard, Hans; Stokholm, Jakob.

In: Clinical Microbiology and Infection, Vol. 28, No. 4, 2022, p. Pages 588-595.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Haahr, T, Clausen, TD, Thorsen, J, Rasmussen, MA, Mortensen, MS, Lehtimäki, J, Shah, SA, Hjelmsø, MH, Bønnelykke, K, Chawes, BL, Vestergaard, G, Jacobsson, B, Larsson, P-G, Brix, S, Sørensen, SJ, Bisgaard, H & Stokholm, J 2022, 'Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section: a prospective cohort study', Clinical Microbiology and Infection, vol. 28, no. 4, pp. Pages 588-595. https://doi.org/10.1016/j.cmi.2021.08.028

APA

Haahr, T., Clausen, T. D., Thorsen, J., Rasmussen, M. A., Mortensen, M. S., Lehtimäki, J., Shah, S. A., Hjelmsø, M. H., Bønnelykke, K., Chawes, B. L., Vestergaard, G., Jacobsson, B., Larsson, P-G., Brix, S., Sørensen, S. J., Bisgaard, H., & Stokholm, J. (2022). Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section: a prospective cohort study. Clinical Microbiology and Infection, 28(4), Pages 588-595. https://doi.org/10.1016/j.cmi.2021.08.028

Vancouver

Haahr T, Clausen TD, Thorsen J, Rasmussen MA, Mortensen MS, Lehtimäki J et al. Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section: a prospective cohort study. Clinical Microbiology and Infection. 2022;28(4):Pages 588-595. https://doi.org/10.1016/j.cmi.2021.08.028

Author

Haahr, Thor ; Clausen, Tine Dalsgaard ; Thorsen, Jonathan ; Rasmussen, Morten A. ; Mortensen, Martin S. ; Lehtimäki, Jenni ; Shah, Shiraz A. ; Hjelmsø, Mathis H. ; Bønnelykke, Klaus ; Chawes, Bo L. ; Vestergaard, Gisle ; Jacobsson, Bo ; Larsson, Per-Göran ; Brix, Susanne ; Sørensen, Søren J. ; Bisgaard, Hans ; Stokholm, Jakob. / Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section : a prospective cohort study. In: Clinical Microbiology and Infection. 2022 ; Vol. 28, No. 4. pp. Pages 588-595.

Bibtex

@article{fefd7f45465345abbb4866de480a1ddb,

title = "Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section: a prospective cohort study",

abstract = "OBJECTIVES: We aimed to investigate changes in vaginal microbiota during pregnancy, and the association between vaginal dysbiosis and reproductive outcomes.METHODS: A total of 730 (week 24) and 666 (week 36) vaginal samples from 738 unselected pregnant women were studied by microscopy (Nugent score) and characterized by 16S rRNA gene sequencing. A novel continuous vaginal dysbiosis score was developed based on these methods using a supervised partial least squares model.RESULTS: Among women with bacterial vaginosis in week 24 (N=53), 47% (N=25) also had bacterial vaginosis in week 36. In contrast, among women without bacterial vaginosis in week 24, only 3% (N=18) developed bacterial vaginosis in week 36. Vaginal samples dominated by Lactobacillus (L.) crispatus (OR 0.35 [0.20-0.60]) and L. iners (OR 0.40 [0.23-0.68]) in week 24 were significantly more stable by week 36 when compared to other vaginal community state types. Vaginal dysbiosis score at week 24 was associated with a significant increased risk of emergency, but not elective, cesarean section (OR 1.37 [1.15-1.64], P<0.001), suggesting a 37% increased risk per standard deviation increase in vaginal dysbiosis score.CONCLUSIONS: Changes in vaginal microbiota from week 24 to week 36 correlated with bacterial vaginosis status and vaginal community state type. A novel vaginal dysbiosis score was associated with a significantly increased risk of emergency, but not elective, cesarean section. This was not found for bacterial vaginosis or any vaginal community state type and could point to the importance of investigating vaginal dysbiosis as a nuanced continuum instead of crude clusters.",

author = "Thor Haahr and Clausen, {Tine Dalsgaard} and Jonathan Thorsen and Rasmussen, {Morten A.} and Mortensen, {Martin S.} and Jenni Lehtim{\"a}ki and Shah, {Shiraz A.} and Hjelms{\o}, {Mathis H.} and Klaus B{\o}nnelykke and Chawes, {Bo L.} and Gisle Vestergaard and Bo Jacobsson and Per-G{\"o}ran Larsson and Susanne Brix and S{\o}rensen, {S{\o}ren J.} and Hans Bisgaard and Jakob Stokholm",

year = "2022",

doi = "10.1016/j.cmi.2021.08.028",

language = "English",

volume = "28",

pages = "Pages 588--595",

journal = "Clinical Microbiology and Infection",

issn = "1198-743X",

publisher = "Elsevier",

number = "4",

}

RIS

TY - JOUR

T1 - Vaginal dysbiosis in pregnancy associates with risk of emergency caesarean section

T2 - a prospective cohort study

AU - Haahr, Thor

AU - Clausen, Tine Dalsgaard

AU - Thorsen, Jonathan

AU - Rasmussen, Morten A.

AU - Mortensen, Martin S.

AU - Lehtimäki, Jenni

AU - Shah, Shiraz A.

AU - Hjelmsø, Mathis H.

AU - Bønnelykke, Klaus

AU - Chawes, Bo L.

AU - Vestergaard, Gisle

AU - Jacobsson, Bo

AU - Larsson, Per-Göran

AU - Brix, Susanne

AU - Sørensen, Søren J.

AU - Bisgaard, Hans

AU - Stokholm, Jakob

PY - 2022

Y1 - 2022

N2 - OBJECTIVES: We aimed to investigate changes in vaginal microbiota during pregnancy, and the association between vaginal dysbiosis and reproductive outcomes.METHODS: A total of 730 (week 24) and 666 (week 36) vaginal samples from 738 unselected pregnant women were studied by microscopy (Nugent score) and characterized by 16S rRNA gene sequencing. A novel continuous vaginal dysbiosis score was developed based on these methods using a supervised partial least squares model.RESULTS: Among women with bacterial vaginosis in week 24 (N=53), 47% (N=25) also had bacterial vaginosis in week 36. In contrast, among women without bacterial vaginosis in week 24, only 3% (N=18) developed bacterial vaginosis in week 36. Vaginal samples dominated by Lactobacillus (L.) crispatus (OR 0.35 [0.20-0.60]) and L. iners (OR 0.40 [0.23-0.68]) in week 24 were significantly more stable by week 36 when compared to other vaginal community state types. Vaginal dysbiosis score at week 24 was associated with a significant increased risk of emergency, but not elective, cesarean section (OR 1.37 [1.15-1.64], P<0.001), suggesting a 37% increased risk per standard deviation increase in vaginal dysbiosis score.CONCLUSIONS: Changes in vaginal microbiota from week 24 to week 36 correlated with bacterial vaginosis status and vaginal community state type. A novel vaginal dysbiosis score was associated with a significantly increased risk of emergency, but not elective, cesarean section. This was not found for bacterial vaginosis or any vaginal community state type and could point to the importance of investigating vaginal dysbiosis as a nuanced continuum instead of crude clusters.

AB - OBJECTIVES: We aimed to investigate changes in vaginal microbiota during pregnancy, and the association between vaginal dysbiosis and reproductive outcomes.METHODS: A total of 730 (week 24) and 666 (week 36) vaginal samples from 738 unselected pregnant women were studied by microscopy (Nugent score) and characterized by 16S rRNA gene sequencing. A novel continuous vaginal dysbiosis score was developed based on these methods using a supervised partial least squares model.RESULTS: Among women with bacterial vaginosis in week 24 (N=53), 47% (N=25) also had bacterial vaginosis in week 36. In contrast, among women without bacterial vaginosis in week 24, only 3% (N=18) developed bacterial vaginosis in week 36. Vaginal samples dominated by Lactobacillus (L.) crispatus (OR 0.35 [0.20-0.60]) and L. iners (OR 0.40 [0.23-0.68]) in week 24 were significantly more stable by week 36 when compared to other vaginal community state types. Vaginal dysbiosis score at week 24 was associated with a significant increased risk of emergency, but not elective, cesarean section (OR 1.37 [1.15-1.64], P<0.001), suggesting a 37% increased risk per standard deviation increase in vaginal dysbiosis score.CONCLUSIONS: Changes in vaginal microbiota from week 24 to week 36 correlated with bacterial vaginosis status and vaginal community state type. A novel vaginal dysbiosis score was associated with a significantly increased risk of emergency, but not elective, cesarean section. This was not found for bacterial vaginosis or any vaginal community state type and could point to the importance of investigating vaginal dysbiosis as a nuanced continuum instead of crude clusters.

U2 - 10.1016/j.cmi.2021.08.028

DO - 10.1016/j.cmi.2021.08.028

M3 - Journal article

C2 - 34500080

VL - 28

SP - Pages 588-595

JO - Clinical Microbiology and Infection

JF - Clinical Microbiology and Infection

SN - 1198-743X

IS - 4

ER -

ID: 281224922

Department of Biology