Document Detail


Pregnancy-induced changes in immune protection of the genital tract: defining normal.
MedLine Citation:
PMID:  23313311     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Both the state of pregnancy as well as disruption of vaginal flora and immune mediators may increase the risk of human immunodeficiency virus (HIV)-1 acquisition.. The objective of this study was to define immune changes in lower genital and systemic immunity associated with normal pregnancy. METHODS: Prospective cohort enrolled low risk pregnant and non-pregnant women ages 18 to 35. Pregnant women at < 14 weeks and non-pregnant women in follicular phase of the menstrual cycle were included. Cervical and vaginal fluid was collected. Concentrations of immune mediators were measured using ELISA-based methods or multiplex immunoassay. Samples were inoculated onto various culture media allowing for growth of Lactobacillus spp, G. vaginalis, E.coli, Enterococcus spp, anaerobic gram-negative rods, Candida, S. aureus, Ureaplasma spp, and Mycoplasma hominis. Concentrations of immune mediators and vaginal colonization frequencies were compared between the pregnant and non-pregnant groups. RESULTS: Genital tract concentration of IL-1β was higher during pregnancy compared to non-pregnant participants. Serum CRP concentrations were higher in all trimesters of pregnancy. Concentrations of secretory leukocyte protease inhibitor didn't differ between groups. Lactobacillus was more commonly isolated from vaginal cultures of non-pregnant participants (100% vs. 70.2%, p=0.02). Identification of Candida, G. vaginalis, M. hominis and S. aureus was common and not different between groups. Ureaplasma spp was isolated from over 60% pregnant participants. CONCLUSIONS: The pro-inflammatory cytokine, IL-1β, as well as the systemic marker of inflammation, CRP, are increased during pregnancy. The impact of these pro-inflammatory changes during pregnancy deserves further study.
Authors:
Brenna L Anderson; Hector Mendez-Figueroa; Joshua D Dahlke; Christina Raker; Sharon L Hillier; Susan Cu-Uvin
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  -     ISSN:  1097-6868     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Mosby, Inc. All rights reserved.
Affiliation:
Division of Maternal Fetal Medicine , Department of Obstetrics and Gynecology, Women & Infants' Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA.. Electronic address: banderson@wihri.org.
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