The influence of race on cervical length in pregnant women in Brazil.
Adult
Brazil
/ epidemiology
Cervical Length Measurement
/ methods
Cervix Uteri
/ diagnostic imaging
Female
Gestational Age
Humans
Maternal Age
Microbiota
/ genetics
Pregnancy
Pregnancy Outcome
/ epidemiology
Premature Birth
/ diagnosis
RNA, Ribosomal, 16S
/ isolation & purification
Race Factors
Ultrasonography, Prenatal
/ methods
Vagina
/ microbiology
cervical length
race
vaginal microbiome
Journal
Journal of perinatal medicine
ISSN: 1619-3997
Titre abrégé: J Perinat Med
Pays: Germany
ID NLM: 0361031
Informations de publication
Date de publication:
26 Mar 2021
26 Mar 2021
Historique:
received:
17
02
2020
accepted:
30
08
2020
pubmed:
23
10
2020
medline:
4
11
2021
entrez:
22
10
2020
Statut:
epublish
Résumé
Short cervical length is a predictor of preterm birth. We evaluated if there were racial differences in variables associated with cervical length in pregnant Brazilian women. Cervical length was determined by vaginal ultrasound in 414 women at 21 weeks gestation. All women were seen at the same clinic and analyzed by the same investigators. Women found to have a short cervix (≤25 mm) received vaginal progesterone throughout gestation. Composition of the vaginal microbiome was determined by analysis of the V1-V3 region of the gene coding for bacterial 16S ribosomal RNA. Demographic, clinical and outcome variables were determined by chart review. Subjects were 53.4% White, 37.2% mixed race and 9.4% Black. Pregnancy, medical history and education level were similar in all groups. Mean cervical length was shorter in Black women (28.4 mm) than in White (32.4 mm) or mixed race (32.8 mm) women (p≤0.016) as was the percentage of women with a short cervix (23.1, 12.2, 7.8% in Black, White, mixed race respectively) (p≤0.026). Mean cervical length increased with maternal age in White (p=0.001) and mixed race (p=0.045) women but not Black women. There were no differences in bacterial dominance in the vaginal microbiota between groups. Most women with a short cervix delivered at term. We conclude that Black women in Brazil have a shorter cervical length than White or mixed race women independent of maternal age, pregnancy and demographic history or composition of the vaginal microbiome.
Identifiants
pubmed: 33090968
doi: 10.1515/jpm-2020-0065
pii: jpm-2020-0065
doi:
Substances chimiques
RNA, Ribosomal, 16S
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
365-369Informations de copyright
© 2020 Walter de Gruyter GmbH, Berlin/Boston.
Références
Blencowe, H, Cousens, S, Oestergaard, MZ, Chou, D, Moller, AB, Narwal, R, et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012;379:2162–172. https://doi.org/10.1016/s0140-6736(12)60820-4 .
doi: 10.1016/s0140-6736(12)60820-4
Goldenberg, RL, Culhane, JF, Iams, JD, Romero, R. Epidemiology and causes of preterm birth. Lancet 2008;371:75–84. https://doi.org/10.1016/s0140-6736(08)60074-4 .
doi: 10.1016/s0140-6736(08)60074-4
Rubems, CE, Sadovsky, Y, MugliaL, Gravett, MG, Lackritz, E, Gravett, C. Prevention of preterm birth: harnessing science to address the global epidemic. Sci Transl Med 2014;6:262sr5. https://doi.org/10.1126/scitranslmed.3009871 .
doi: 10.1126/scitranslmed.3009871
Iams, JD, Goldenberg, RL, Meis, PJ, Mercer, BM, Moawad, A, Das, A, et al. The length of the cervix and the risk of spontaneous preterm delivery. National Institute of Child Health and Human Development Maternal Fetal Medicine Unit Network. N Engl J Med 1996;334:567–72. https://doi.org/10.1056/nejm199602293340904 .
doi: 10.1056/nejm199602293340904
Fonseca, EB, Celik, E, Parra, M, Singh, M, Nicolaides, KH. Progesterone and the risk of preterm birth among women with a short cervix. N Engl J Med 2007;357:462–9. https://doi.org/10.1056/nejmoa067815 .
doi: 10.1056/nejmoa067815
Hassan, SS, Romero, R, Vidyadhan, D, Fusey, S, Baxter, JK, Khandelwal, M, et al. Vaginal progesterone reduces the rate of preterm birth in women with a sonographic short cervix: a multicenter, randomized double-blind, placebo-controlled trial. Ultrasound Obstet Gynecol 2011;38:18–31. https://doi.org/10.1002/uog.9017 .
doi: 10.1002/uog.9017
Rozenberg, P. Universal cervical length screening for singleton pregnancies with no history of preterm delivery, or the inverse of the Pareto principle. BJOG 2017;124:1038–45. https://doi.org/10.1111/1471-0528.14392 .
doi: 10.1111/1471-0528.14392
Heath, VC, Southall, TR, Souka, AP, Novakov, A, Nicolaides, KH. Cervical length at 23 weeks of gestation: relation to demographic characteristics and previous obstetric history. Ultrasound Obstet Gynecol 1998;12:304–11. https://doi.org/10.1046/j.1469-0705.1998.12050304.x .
doi: 10.1046/j.1469-0705.1998.12050304.x
Miller, ES, Tita, AT, Grobman, WA. Second-trimester cervical length screening among asymptomatic women. An evaluation of risk-based strategies. Obstet Gynecol 2015;126:61–6. https://doi.org/10.1097/aog.0000000000000864 .
doi: 10.1097/aog.0000000000000864
Buck, JN, Orzechowski, KM, Berghella, V. Racial disparities in cervical length for prediction of preterm birth in low risk population. J Matern Fetal Neonatal Med 2017;30:1851–4. https://doi.org/10.1080/14767058.2016.1228056 .
doi: 10.1080/14767058.2016.1228056
Nasioudis, D, Forney, LJ, Schneider, GM, Gliniewicz, K, France, M, Boester, A, et al. Influence of pregnancy history on the vaginal microbiome of pregnant women in their first trimester. Sci Rep 2017;7:10201. https://doi.org/10.1038/s41598-017-09857-z .
doi: 10.1038/s41598-017-09857-z
Ravel, J, Gajer, P, Abdo, Z, Schneider, GM, Koenig, SSK, McCulle, SL, et al. Vaginal microbiome of reproductive-age women. Proc Natl Acad Sci USA 2011;108:4680–7. https://doi.org/10.1073/pnas.1002611107 .
doi: 10.1073/pnas.1002611107
Romero, R, Hassan, SS, Gajer, P, Tarca, AL, Fadrosh, DW, Nikita, L, et al. The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women. Microbiome 2014;2:4. https://doi.org/10.1186/2049-2618-2-10 .
doi: 10.1186/2049-2618-2-10
Parra, FC, Amado, RC, Lambertucci, JR, Rocha, J, Antunes, CM, Pena, SDJ. Color and genomic ancestry in Brazilians. Proc Natl Acad Sci USA 2003;100:177–82. https://doi.org/10.1073/pnas.0126614100 .
doi: 10.1073/pnas.0126614100
de Neves Manta, FS, Pereira, R, Vianna, R, de Araujo, AR, Gital, DL, da Silva, DA, et al. Revisiting the genetic ancestry of Brazilians using autosomal AIM-Indels. PloS One 2013;8: e75145. https://doi.org/10.1371/journal.pone.0075145 .
doi: 10.1371/journal.pone.0075145
Kindinger, LM, Bennett, PR, Lee, YS, Marchesi, JR, Smith, A, Cacciatore, S, et al. The interaction between vaginal microbiota, cervical length, and vaginal progesterone treatment for preterm birth risk. Microbiome 2017;5:6. https://doi.org/10.1186/s40168-016-0223-9 .
doi: 10.1186/s40168-016-0223-9
Nguyen, DP, Genc, M, Vardhana, S, Babula, O, Onderdonk, A, Witkin, SS. Ethnic differences of polymorphisms in cytokine and innate immune system genes in pregnant women. Am J Obstet Gynecol 2004;104:293–300. https://doi.org/10.1097/01.aog.0000133486.85400.5e .
doi: 10.1097/01.aog.0000133486.85400.5e
Jaffe, S, Normand, N, Jayaran, A, Orfanelli, T, Doulaveris, G, Passos, M, et al. Unique variation in genetic selection among Black North American women and its potential influence on pregnancy outcome. Med Hypothesis 2013;81:91823. https://doi.org/10.1016/j.mehy.2013.08.015 .
doi: 10.1016/j.mehy.2013.08.015
Beghini, J, Linhares, IM, Giraldo, PC, Ledger, WJ, Witkin, SS. Differential expression of lactic acid isomers, extracellular matrix metalloproteinase inducer, and matrix metalloproteinase-8 in vaginal fluid from women with vaginal disorders. BJOG 2015;122:1580–5. https://doi.org/10.1111/1471-0528.13072 .
doi: 10.1111/1471-0528.13072
Eglinton, GS, Herway, C, Skuski, DW, Bongiovanni, AM, Witkin, SS. Endocervical hyaluronan and ultrasound-indicated cerclage. Ultrasound Obstet Gynecol 2011;37:214–18. https://doi.org/10.1002/uog.7756 .
doi: 10.1002/uog.7756
Kishida, T, Yamada, H, Furuta, I, Kobayashi, N, Hirayama, EK, Ebina, Y, et al. Factors affecting matrix metalloproteinase-8 levels in the vaginal and cervical fluids in the first and second trimester of pregnancy. Hum Reprod 2009;24:2693–702. https://doi.org/10.1093/humrep/dep284 .
doi: 10.1093/humrep/dep284