Bacterial vaginosis (BV) is a highly prevalent vaginal condition that has been associated with a number of pregnancy complications, including spontaneous preterm births (sPTB). A number of risk factors for BV have been identified yet its etiology is not understood. Few studies have investigated the role of nutrition in the etiology of BV. Maternal iron and folate status may be important in the development of BV as they play key roles in host immunity. The purpose of this review is to critically evaluate the literature and provide support to the hypothesis that certain micronutrients, iron, and folate, are risk factors for BV early in pregnancy. Iron and folate may be important in both humoral and cell-mediated innate immunity, respectively. Both facets of innate immunity are important in the control of BV. Preliminary data suggests that vitamin D is associated with BV early in pregnancy. In a prospective cohort study, pregnant women enrolled at <16 weeks were followed through delivery. Serum collected at enrollment was analyzed for 25-hydroxyvitamin D (25(OH)D) and Gram-stained vaginal smears were evaluated for BV using Nugent criteria. Multivariable logistic regression was used to determine the association between 25(OH)D and BV while adjusting for a number of confounders. The association between vitamin D and BV varied by race (likelihood ratio test, p=0.09). A 50-nmol/l decrease in 25OHD was associated with a 4.2-fold (95% CI, 2.1, 8.1) increase in the odds of BV in black women. Among white women, there was no association between maternal 25(OH)D and BV. These results indicate that maternal vitamin D deficiency is associated with BV in early pregnancy among black, but not white women. Studies such as these are of great public health significance because maternal nutrition is modifiable, and interventions to improve maternal nutritional status can be safe, inexpensive, and readily acceptable to patients.
| Identifer | oai:union.ndltd.org:PITT/oai:PITTETD:etd-06082009-102916 |
| Date | 29 September 2009 |
| Creators | Bobo, Tanya |
| Contributors | Marijane A. Krohn, PhD, Catherine Haggerty, PhD, MPH, Lisa M. Bodnar, PhD, MPH, RD |
| Publisher | University of Pittsburgh |
| Source Sets | University of Pittsburgh |
| Language | English |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | http://etd.library.pitt.edu/ETD/available/etd-06082009-102916/ |
| Rights | unrestricted, I hereby certify that, if appropriate, I have obtained and attached hereto a written permission statement from the owner(s) of each third party copyrighted matter to be included in my thesis, dissertation, or project report, allowing distribution as specified below. I certify that the version I submitted is the same as that approved by my advisory committee. I hereby grant to University of Pittsburgh or its agents the non-exclusive license to archive and make accessible, under the conditions specified below, my thesis, dissertation, or project report in whole or in part in all forms of media, now or hereafter known. I retain all other ownership rights to the copyright of the thesis, dissertation or project report. I also retain the right to use in future works (such as articles or books) all or part of this thesis, dissertation, or project report. |
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