High sialidase levels increase preterm birth risk among women who are bacterial vaginosis–positive in early gestation

• Published in: American journal of obstetrics and gynecology Vol. 204; no. 2; pp. 142.e1 - 142.e9
• Main Authors: Cauci, Sabina, PhD, Culhane, Jennifer Flatow, PhD, MPH
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.02.2011; Elsevier
• Subjects: Adult; adverse pregnancy outcome; Bacterial diseases; Bacterial diseases of the genital system; bacterial vaginosis; Biological and medical sciences; Chi-Square Distribution; Diseases of mother, fetus and pregnancy; Female; Gestational Age; Gynecology. Andrology. Obstetrics; Human bacterial diseases; Humans; Infectious diseases; Kaplan-Meier Estimate; Medical sciences; miscarriage; Neuraminidase - metabolism; Obstetrics and Gynecology; Odds Ratio; Pregnancy; Pregnancy Complications, Infectious - diagnosis; Pregnancy Complications, Infectious - microbiology; Pregnancy Outcome; Pregnancy Trimester, First; Pregnancy. Fetus. Placenta; Premature Birth - etiology; preterm birth; Risk; sialidase; Vagina - enzymology; Vagina - microbiology; Vaginal Smears; Vaginosis, Bacterial - diagnosis; Vaginosis, Bacterial - microbiology; preterm birth; sialidase; adverse pregnancy outcome; bacterial vaginosis; miscarriage; Human; Pregnancy disorders; Gynecology; Premature delivery; Vaginal diseases; Obstetrics; Female genital diseases; Infection; Pregnancy; Bacterial vaginosis; Prematurity; Risk factor; Bacteriosis; Female; Early; Woman
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/j.ajog.2010.08.061

Objective The purpose of this study was to assess whether vaginal sialidases level in early pregnancy is associated with preterm birth among women who are bacterial vaginosis–positive. Study Design Of the 1806 women who were enrolled at <20 weeks of gestation, 800 of the women were bacterial vaginosis–positive (Nugent score, 7-10); 707 of the women had birth outcome data; 109 of the women who were bacterial vaginosis–positive had an adverse preterm outcome, which included 53 spontaneous preterm births (19 births were early at 20-34 weeks, and 34 births were late at 34-37 weeks), and 14 of the women had late miscarriages (12-20 weeks). Sialidase levels were compared with 352 control subjects (term normal birthweight infants). Results Sialidase levels at ≥5, ≥10, and ≥14 nmol (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.01–2.41; OR, 2.14; 95% CI, 1.25–3.64; OR, 3.17; 95% CI, 1.64–6.10, respectively) was associated significantly with all adverse preterm outcomes. The ≥10 nmol and ≥14 nmol cut-points were associated strongly with early spontaneous preterm births (OR, 3.79; 95% CI, 1.42–10.10 and OR, 5.36; 95% CI, 1.77–16.23, respectively) and late miscarriages (OR, 4.87; 95% CI, 1.61–14.65; OR, 8.33; 95% CI, 2.57–26.9, respectively). Conclusion Elevated sialidase level that is measured at 12 weeks of gestation is associated strongly with early spontaneous preterm births and late miscarriage.