Evidence map›Paper›PMID 38949435›Full record

ArticlePaediatric and perinatal epidemiology2024

A prospective cohort study examining the association between the periconceptual vaginal microbiota and first-trimester miscarriage in Kenyan women.

R Scott McClelland, Erica M Lokken, John Kinuthia, Sujatha Srinivasan, Barbra A Richardson, Walter Jaoko, Sophia Lannon, Anne Pulei, Tina L Fiedler, Matthew M Munch and 3 more

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In one paragraph

Article in Paediatric and perinatal epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

R Scott McClellandDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Erica M LokkenDepartment of Global Health, University of Washington, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-3285-4751
John KinuthiaDepartment of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya.
Sujatha SrinivasanVaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.ORCID https://orcid.org/0000-0002-7267-3859
Barbra A RichardsonDepartment of Global Health, University of Washington, Seattle, Washington, USA.
Walter JaokoDepartment of Medical Microbiology and Immunology, University of Nairobi, Nairobi, Kenya.
Sophia LannonNorthwest Perinatal, Women's Healthcare Associates, Portland, Oregon, USA.
Anne PuleiDepartment of Obstetrics and Gynaecology, University of Nairobi, Nairobi, Kenya.
Tina L FiedlerVaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
Matthew M MunchVaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
Sean ProllVaccine and Infectious Disease Division, Fred Hutchinson Cancer Center, Seattle, Washington, USA.
Grace John-StewartDepartment of Medicine, University of Washington, Seattle, Washington, USA.
David N FredricksDepartment of Medicine, University of Washington, Seattle, Washington, USA.

Funding

Transform Dissemination and Implementation Science in CTSA ProgramsUL1TR002319 · NCATS · UNIVERSITY OF WASHINGTON · PI John K. Amory · 2017 to 2026
$100.0M
VENEREAL DISEASET32AI007140 · NIAID · UNIVERSITY OF WASHINGTON · PI Julia Cook Dombrowski · 1985 to 2026
$19.4M
Impact of periconceptual vaginal microbiota on women's risk of preterm birthR01HD087346 · NICHD · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, RAYMOND SCOTT · 2016 to 2020
$3.3M
Assessing vaginal microbial communities as a risk factor for HIV acquisition in pregnant and postpartum Kenyan womenF32HD100202 · NICHD · UNIVERSITY OF WASHINGTON · PI LOKKEN, ERICA M · 2019 to 2022
$159k
NCATS NIH HHS UL1 TR002319NIAID NIH HHS T32 AI007140NIAID NIH HHS T32 AI07140NICHD NIH HHS F32 HD100202NICHD NIH HHS R01 HD087346NICHD NIH HHS R01 HD87346-RSMUnited States National Institutes of Health
6 · The paper itself

Abstract

backgroundStudies evaluating the association between the vaginal microbiota and miscarriage have produced variable results.

objectiveThis study evaluated the association between periconceptual and first-trimester vaginal microbiota and women's risk for miscarriage.

methodsAt monthly preconception visits and at 9-12 weeks gestation, women collected vaginal swabs for molecular characterisation of the vaginal microbiota. Participants who became pregnant were followed to identify miscarriage versus pregnancy continuing to at least 20 weeks gestation.

resultsForty-five women experienced miscarriage and 144 had pregnancies continuing to ≥20 weeks. A principal component analysis of periconceptual and first-trimester vaginal bacteria identified by 16S rRNA gene PCR with next-generation sequencing did not identify distinct bacterial communities with miscarriage versus continuing pregnancy. Using taxon-directed quantitative PCR assays, increasing concentrations of Megasphaera hutchinsoni, Mageeibacillus indolicus, Mobiluncus mulieris and Sneathia sanguinegens/vaginalis were not associated with miscarriage. In exploratory analyses, these data were examined as a binary exposure to allow for multivariable modelling. Detection of Mobiluncus mulieris in first-trimester samples was associated with miscarriage (adjusted relative risk [aRR] 2.14, 95% confidence interval [CI] 1.08, 4.22). Additional analyses compared women with early first-trimester miscarriage (range 4.7-7.3 weeks) to women with continuing pregnancies. Mobiluncus mulieris was detected in all eight (100%) first-trimester samples from women with early first-trimester miscarriage compared to 101/192 (52.6%) samples from women with continuing pregnancy (model did not converge). Detection of Mageeibacillus indolicus in first-trimester samples was also associated with early first-trimester miscarriage (aRR 4.10, 95% CI 1.17, 14.31).

conclusionsThe primary analyses in this study demonstrated no association between periconceptual or first-trimester vaginal microbiota and miscarriage. Exploratory analyses showing strong associations between first-trimester detection of Mobiluncus mulieris and Mageeibacillus indolicus and early first-trimester miscarriage suggest the need for future studies to determine if these findings are reproducible.

Indexed as

Abortion, SpontaneousMicrobiotaPregnancy Trimester, FirstVaginaAdultFemaleHumansKenyaPregnancyProspective StudiesRNA, Ribosomal, 16SYoung AdultRNA, Ribosomal, 16SMageeibacillus indolicusMegasphaera hutchinsonimicrobiomemiscarriageMobiluncus mulierisSneathia

Identifiers

PMID38949435
PMCPMC11590749

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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.