Study links diverse Gardnerella species in pregnant women to higher preterm birth risk (2024)

Study links diverse Gardnerella species in pregnant women to higher preterm birth risk (1)By Pooja Toshniwal PahariaMay 26 2024Reviewed by Benedette Cuffari, M.Sc.

In a recent study published in the journal mSystems, researchers investigate the richness of Gardnerella species and clades in the vagin*l microbiome of pregnant women and their impact on premature delivery.

Study links diverse Gardnerella species in pregnant women to higher preterm birth risk (2) Study:Gardnerelladiversity and ecology in pregnancy and preterm birth. Image Credit: Kateryna Kon / Shutterstock.com

Gardnerella and the vagin*l microbiome

Certain vagin*l microbiota species have been associated with unfavorable health consequences such as sexually transmitted diseases (STDs), cervical cancer, premature delivery, and bacterial vaginosis. For example, the Gardnerella species has been recognized as a risk factor for several disorders.

Gardnerella generates sialidase, which degrades protective mucins in the vagin* and increases host inflammatory responses. However, Gardnerella may be present in various amounts in the vagin* without causing any symptoms or disease.

About the study

In the current study, researchers create a computer technique for identifying Gardnerella clades and species in vagin*l microbiomes, in addition to evaluating the abundance of Gardnerella in association with preterm births.

To this end, the relative abundances of Gardnerella clades, genomic species, and other taxa were determined using shotgun metagenomic sequences obtained from pregnant female cohorts. Samples were obtained from study participants in the Multi-Omic Microbiome Study: Pregnancy Initiative (MOMS-PI), UAB-enriched, and Stanford-enriched cohorts, which provided 781, 45, and 62 samples from 231, 15, and 20 individuals, respectively.

An additional MOMS-PI-enriched cohort, which included 145 samples from 42 individuals, was created. This cohort comprised MOMS-PI subsamples to match theGardnerella relative abundance distributions of the UAB and Stanford-enriched cohorts.

The researchers developed and quantitatively validated a technique to detect Gardnerella species from vagin*l microbiomes. Thereafter, this method was used to assess the abundance of six clades comprising 14 genomic species in vagin*l swabs collected from the three cohorts.

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The researchers determined whether the presence of various Gardnerella clades during pregnancy was related to a distinct preterm delivery risk. The Gardnerella amplicon sequence variation (ASV) abundance in the vagin*l microbiome was also determined.

The phylogeny of Gardnerella was assessed to reveal subspecies clades and cpn60 variations, thereby providing a thorough understanding of its evolutionary connections.

Assemblies that did not align with reference 16S sequences were also evaluated by aligningthem tothe nt or nr databases. GCA_902362445.1 and GCA_002871555.1, suspected of containing Lactobacillus vagin*lis strains, were not included in the analysis.

Assembly quality and completeness were both evaluated. The collection of genetic assemblies was de-replicated after selecting representative genomes from every genome cluster within a 0.005-mash distance based on assembly quality and completeness determined by contig L50 and N50 values.

Study findings

Individual microbiomes frequently comprised numerous Gardnerella variations. These clade counts were directly proportional to microbial burdens and non-human to-human genetic reads ratios, thus indicating a potential association between Gardnerella abundance and preterm birth risk.

Constant taxon co-occurrences were observed among Gardnerella genetic clades and study cohorts. Some previously reported uncommon variations were identified in additional cohorts, emphasizing the significance of surveying several individuals to capture Gardnerella diversity.

In October 2020, the researchers constructed a Gardnerella core-genome phylogeny using GenBank assemblies. Among 12,105 pangenome genes, 85 core genes were identified.Gardnerella had a median relative abundance of 17% and 45% in the unenriched and enriched MOMS-PI cohorts, respectively.

The present genomic census supports 14 Gardnerella genomic species and six different clades, including four previously reported clades and two isolate-based clades. Four strain groups were also identified, including G. vagin*lis, GS4 Gardnerella piotii, GS5 G. leopoldii, and GS6 Gardnerella swindinskii. Moreover, four of the Gardnerella ASVs were categorized into cohesive evolutionary groups G1, G2, G4, and G5.

Comparable trends in Gardnerella variant richness and prevalence were observed across cohorts, with the first through fourth clades more common than the fifth and sixth clades. The third clade was particularly abundant and widespread among African American individuals. Comparatively, the fifth and sixth clades had the lowest prevalence across all cohorts; however, they were abundant among UAB-enriched group individuals.

Gardnerella coexistence patterns were similar across clades, with enriched cohorts associated with greater average relative abundances. Preterm delivery was associated with increased Gardnerella richness and microbial burden; however, no significant correlation changes were observed in all four cohorts.

Conclusions

vagin*l microbiomes of pregnant women comprise diverse Gardnerella variants, with numerous clades in individual microbiota, thus indicating high diversity within the species. The number of clades was associated with higher microbial load, which indicates a potential association between Gardnerella diversity and microbiota composition.

Six clades and 14 genomic species were present in three cohorts, with the best-characterized clades appearing most often. Multiple Gardnerella strains were detected in a single vagin*l microbiome, thus demonstrating the reliability of the ratio approach.

Gardnerella species are common in microbiomes, with some occurring more frequently in specific populations. Further research is needed to improve the understanding of their ecological activities, interactions, and influences on microbial ecosystems, preterm births, and health outcomes.

Journal reference:

  • Berman,H. L.,Goltsman,D. S. A.,Anderson,M.,et al. (2024).Gardnerelladiversity and ecology in pregnancy and preterm birth. mSystems. doi:10.1128/msystems.01339-23
Study links diverse Gardnerella species in pregnant women to higher preterm birth risk (2024)

FAQs

Study links diverse Gardnerella species in pregnant women to higher preterm birth risk? ›

Study findings

Is gardnerella bad during pregnancy? ›

Introduction: Gardnerella vagin*lis (GV)-associated bacterial vaginosis is recognised for its detrimental effects on pregnancy resulting in poor obstetric and neonatal outcomes. There is limited knowledge of the effects on placental histomorphology following GV infection in pregnancy.

How often does BV cause preterm labor? ›

However, patients in the BV positive group had a significantly higher percentage of preterm birth, below 34 weeks gestation (22.7% vs. 6.2%, p = 0.019) and lower gestational age upon delivery (37.3 vs. 38.1 weeks, p = 0.010) as compared to the negative control group.

Can BV harm my unborn baby? ›

If you have BV during pregnancy, your baby is at increased risk for preterm birth and low birthweight. Preterm birth is birth before 37 weeks of pregnancy. Low birthweight is when your baby is born weighing less than 5 pounds, 8 ounces. Being born too early or too small can cause health problems for your baby.

Has anyone had preterm labor due to BV forum? ›

There was a significantly higher preterm birth rate, below 34 weeks (22.7% vs. 6.2%, p = 0.019) in women with BV. There was no statistically significant difference in maternal outcome such as clinical chorioamnionitis or endometritis.

What does it mean if you test positive for Gardnerella? ›

Gardnerella vagin*lis is a bacteria that coexists alongside other bacteria in your vagin* to keep it infection-free. When too much gardnerella bacteria grows, you can develop an infection called bacterial vaginosis (BV). BV is the most common vagin*l infection and can be easily treated with antibiotics.

Should I be worried about Gardnerella? ›

Gardnerella infection poses distinctive challenges due to its far-reaching implications on women's reproductive health, susceptibility to sexually transmitted diseases, and potential to give rise to complications during pregnancy.

What is the most common infection causing preterm labor? ›

Chorioamnionitis is an inflammation of the amniotic sac and placenta caused by an infection of the fetus. It often takes years for symptoms of many infections to manifest. Histological chorioamnionitis is frequently linked to preterm births before 30 weeks of gestation in about 50% of cases [56].

What STD causes preterm labor? ›

Maternal sexually transmitted infections (gonorrhea, syphilis, or chlamydia) were associated with an increased risk of preterm birth.

What happens if you deliver a baby while having BV? ›

Some types of vaginitis can cause problems during pregnancy. Pregnant women with bacterial vaginosis (BV) are more likely to go into labor and give birth too early (preterm). Preterm infants may face a number of health challenges, including low birth weight and breathing problems.

Can BV cause fetal death? ›

Conclusion: Findings of the study indicate that rates of intra uterine fetal death, preterm labor and premature rupture of membrane were higher in women who had bacterial vaginosis compared with those who did not.

Has anyone had a miscarriage due to BV? ›

Bacterial Vaginosis

While BV can produce symptoms, some women with BV have no symptoms at all. Some studies have tied bacterial vaginosis to both first- and second-trimester miscarriage, as well as higher risk of preterm delivery.

Has anyone gotten pregnant with BV? ›

There is no indication that BV affects a woman's ability to get pregnant. However, BV is associated with certain risks to the fetus, including delivering an infant preterm (before 37 weeks of pregnancy) and delivering an infant with a low birth weight (generally, 5.5 pounds or less).

What does BV smell like? ›

BV is responsible for the fishy smell most commonly associated with unpleasant vagin*l odors. The fishy smell may be especially strong after sex. Another common symptom to look out for with BV is a gray or grayish-white discharge. Trichom*oniasis: A sexually transmitted infection caused by a parasite.

Can gardnerella cause preterm labor? ›

Recent studies have shown that bacterial vaginosis, a noninflammatory overgrowth of anaerobic species (including Bacteroides species, Peptostreptococcus species and Gardnerella vagin*lis), is associated with preterm delivery in high-risk patients.

How do you treat BV to prevent preterm birth? ›

Conclusions: Clindamycin, but not metronidazole, was beneficial in studies providing IPD, but after imputing data from missing IPD studies, treatment of BV during pregnancy did not reduce PTD, nor prolong pregnancy, in any subgroup or when started earlier in gestation.

Can bacterial vaginosis cause miscarriage? ›

Bacterial vaginosis (BV) is related to the increased risk of miscarriage, preterm labor, and postpartum endometritis.

Can a man give a woman Gardnerella? ›

Gardnerella can be spread by sexual contact and is most frequently observed as occurring from women to men and from women to women. It has not been definitively established that men can transmit a Gardnerella infection to women. BV develops when the natural balance of bacteria in the vagin* is disrupted.

What are the most common infections in pregnancy? ›

During pregnancy, some common infections that may occur are the flu, vagin*l yeast infections, uterine infections, group B streptococcus, bacterial vaginosis, and listeria. Changes in immune function may cause this increased risk of infection, and if left untreated, may lead to serious complications.

Why does Gardnerella keep coming back? ›

Recurrent BV might happen when the infection isn't fully treated, something messes up the balance of your bacteria again, or a layer of microorganisms known as a biofilm forms to protect BV-causing bacteria. Besides disrupting your work and sex life, recurrent BV can also lead to serious complications.

References

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