ArticleAmerican journal of epidemiology2021
Perceived Stress and Molecular Bacterial Vaginosis in the National Institutes of Health Longitudinal Study of Vaginal Flora.
Article in American journal of epidemiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- "We adjusted for race": now what? A systematic review of utilization and reporting of race in American Journal of Epidemiology and Epidemiology, 2020-2021.Epidemiologic reviews · 2023Pooled it
- The cervicovaginal gut microbiota axis as a key determinant of systemic physiology.Gut microbes · 2026Review
- Vaginal microbiomes and their pertinent social context: a microbial ecological review proffering AMR-STI acquisition and emergence.Biology of sex differences · 2026Review
- Comparing Asymptomatic Versus Symptomatic Bacterial Vaginosis: Clinical Characteristics, Vaginal Microbiota, and Lactic Acid Profiles.Sexually transmitted diseases · 2026Article
- Characteristics associated with Lactobacillus-depleted vaginal microbiota in women with different sexual behavior.Scientific reports · 2026Article
- Microbial Dysbiosis and Pathogenic Interplay in the Gut-Vaginal Axis: Implications for Polycystic Ovary Syndrome: A Critical Review.Current microbiology · 2026Review
- PAX1/JAM3 methylation in cervical exfoliated cells: a robust diagnostic biomarker for cervical high-grade lesions associated with vaginal dysbiosis.BMC women's health · 2026Article
- Vaginal microbiota in assisted reproduction: determinants, dynamics, and impact on clinical outcomes.Frontiers in microbiology · 2026Review
- The female reproductive tract microbiotas, inflammation, and gynecological conditions: mechanisms, therapeutic advances, and future perspectives.Frontiers in microbiology · 2026Review
- The neovaginal microbiota, symptoms, and local immune correlates in transfeminine individuals with penile inversion vaginoplasty.Cell reports · 2025Article
- Microbiome impacts quality of life in patients with endometrial cancer and benign gynecological conditions.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025Article
- Affective symptoms in pregnancy are associated with the vaginal microbiome.Journal of affective disorders · 2025Article
- The association between lifestyle factors and the composition of the vaginal microbiota: a review.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Review
- Host factors are associated with vaginal microbiome structure in pregnancy in the ECHO Cohort Consortium.Scientific reports · 2024Article
- Does "all disease begin in the gut"? The gut-organ cross talk in the microbiome.Applied microbiology and biotechnology · 2024Review
- Affective Symptoms in Pregnancy are Associated with the Vaginal Microbiome.bioRxiv : the preprint server for biology · 2024Article
- Bacterial vaginosis testing gaps for transmasculine patients may exacerbate health disparities.Frontiers in reproductive health · 2024Article
- Joint effects of individual socioeconomic status and residential neighborhood context on vaginal microbiome composition.Frontiers in public health · 2023Article
- Cervicovaginal mucus barrier properties during pregnancy are impacted by the vaginal microbiome.Frontiers in cellular and infection microbiology · 2023Article
- Review
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
Vaginal microbiota provide the first line of defense against urogenital infections primarily through protective actions of Lactobacillus species Perceived stress increases susceptibility to infection through several mechanisms, including suppression of immune function. We investigated whether stress was associated with deleterious changes to vaginal bacterial composition in a subsample of 572 women in the Longitudinal Study of Vaginal Flora, sampled from 1999 through 2002. Using Cox proportional hazards models, both unadjusted and adjusted for sociodemographic factors and sexual behaviors, we found that participants who exhibited a 5-unit-increase in Cohen's Perceived Stress Scale had greater risk (adjusted hazard ratio (HR) = 1.40, 95% confidence interval (CI): 1.13, 1.74) of developing molecular bacterial vaginosis (BV), a state with low Lactobacillus abundance and diverse anaerobic bacteria. A 5-unit increase in stress score was also associated with greater risks of transitioning from the L. iners-dominated community state type (26% higher) to molecular-BV (adjusted HR = 1.26, 95% CI: 1.01, 1.56) or maintaining molecular-BV from baseline (adjusted HR = 1.23, 95% CI: 1.01, 1.47). Inversely, women with baseline molecular-BV reporting a 5-unit stress increase were less likely to transition to microbiota dominated by L. crispatus, L. gasseri, or L. jensenii (adjusted HR = 0.81, 95% CI: 0.68, 0.99). These findings suggest that psychosocial stress is associated with vaginal microbiota composition, inviting a more mechanistic exploration of the relationship between psychosocial stress and molecular-BV.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.