Recurrent miscarriage patients with
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elevated peripheral NK cells have more Gardnerella vaginalis and gram-negative anaerobes, demonstrating VBM association with changes in immune parameters and miscarriage. Bacterial vaginosis is found in 15-23% of pregnant women, half of whom are asymptomatic, with abnormal VBM in early pregnancy associated with a 5-fold increase in late miscarriage and early PTB. Short cervix in the second trimester is a risk factor for PTB and studies show a signifi- cant association with Lactobacillus iners being dominant at 16 weeks gestation with both a short cervix and PTB. When Lacto- bacillus crispatus is dominant, it is highly predictive of term birth. Addressing VBM changes and other reproductive pathogenic infections is vital for preconception care and prevention of PTB.
Maternal Reproductive Microbiome Treatment for PTB Prevention
1.Preconception. Both partners need a full assessment of current and past infec- tions, immune function status, stress levels, exercise regimen, contraception choices, optimal weight balance and dietary practices, oral hygiene, past an- tibiotic use and avoidance, and proper promotion of Lactobacillus species to fully understand the potential occur- rence for PTB.
2.Pre and probiotic
supplementation benefits. Maternal:
• Reduction of preterm birth, gestational diabetes, gestational weight gain, and preeclampsia
• Prevention of group B streptococcus colonization
• Reduction postpartum depression IMAGINE FLOAT is
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• Alleviation of GI related complaints and antibiotic associated side effects
• Heavy metal and pesticide detoxification
• Reduction in vaginal and urinary tract infections
Neonatal: • Reduction in colic
• Elimination of necrotizing enterocolitis (NEC), atopy, neurological disorders
• Support for allergies • Reduction in antibiotic resistance
• Development of healthy immune system with proper maternal priming
3.Probiotics. Cochrane meta-analysis showed 81% reduction in genital infec- tions with oral probiotics alone. Probiot- ics have been proven to compete with and inhibit pathogen growth, thereby balancing the inflammatory cascade commonly observed in PTB. Lactoba- cillus crispatus and Bifidobacterium species are applied as a vaginal paste to improve VBM. Probiotic gargles can help with oral dysbiosis and allow for healthy microbiome repopulation.
4.Dietary. Dietary support is essential for VBM health. Studies show after one month on a standard American diet, a 71% increase in endotoxin activity. Endotoxins are an integral component of the outer membrane of gram-negative bacteria; E. coli, chlamydia and gonor- rhea are all gram-negative bacteria. A sedentary lifestyle results in higher levels of endotoxins too, so get the body mov- ing and eat a whole foods diet.
5.Prebiotics. Food for the friendly probiotics and fiber are necessary in growing a healthy microbiome. Inu- lin, fructo-oligosaccharides, lactulose, galacto-oligosaccharides, psyllium, and resistant starch can all help VBM. Apple cider vinegar and pink salt are benefi- cial in electrolyte status and regulat- ing pH. Lower vaginal pH improves Lactobacillus growth and diminishes Gardnenella and harmful bacteria over- growth. Fermented foods are helpful in reasonable amounts, don’t overdo them. Avoidance of sugar, yeast, alcohol, and caffeine will improve the overall status of the microbiome.
6.Essential oil. Tea tree, sandalwood, or thyme oils are used in cervicovaginal washes for their antimicrobial actions. Prior to pregnancy thyme essential oil with salt can be used as a gargle for oral health. See a trained professional for preparation and application instructions of essential oils.
7.Supplements. CoQ10 can be used a swish and swallow during pregnancy for mouth and gum health. Vitamin C boosts immune function for better main- tenance of a healthy microbiome. Oral berberine modulates the gut microbi- ome through enriching short chain fatty acid producing bacteria and reducing microbial diversity. Progesterone helps with embryo implantation and main- taining pregnancy in the first trimester and it is now known to regulate Bifido- bacterium. Therefore, if progesterone is deficient, PTB may increase due to the low levels of Bifidobacterium.
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