Principal investigator: Mark A. Klebanoff, M.D., M.P.H.
This project uses previously, as well as newly collected data to study various aspects of abnormal genital tract flora. Its purpose is to explore various aspects of the association between bacterial vaginosis and pregnancy outcome, as well as to understand the various behavioral and biological factors associated with the acquisition, maintenance, and remission of bacterial vaginosis. Previously collected data sets include the Maternal-Fetal Medicine Network (MFMU) clinical trial, conducted in 1996-2000, in which approximately 30,000 women were screened for bacterial vaginosis and trichomoniasis, and those who were positive were randomized to treatment with metronidazole or placebo; the Vaginal Infections and Prematurity Study (1984-1989), in which approximately 14,000 pregnant women had detailed genital tract microbiological evaluation done at 23-26 weeks' gestation, answered detailed questionnaires, and had a variety of pregnancy outcomes assessed. Newly collected data include the Longitudinal Study of Vaginal Flora, in which 3,620 non-pregnant women underwent quarterly study visits, including vaginal Gram stains and limited cultures and detailed questioning regarding a variety of behavioral factors, for one year. Analysis of the Flora study is just beginning.
 
DESPR Collaborators

· Jun (Jim) Zhang, M.D., Ph.D.
· Kai F. Yu, Ph.D.
· Tonja R. Nansel, Ph.D.

Selected Publications

Klebanoff MA, Andrews WW, Yu KF, Brotman RM, Nansel TR, Zhang J, Cliver SP, & Schwebke JR. (2006). A pilot study of vaginal flora changes with randomization to cessation of douching. Sex Transm Dis, 33(10):610-613. [Abstract]

Andrews WW, Klebanoff MA, MacPherson C, Hauth JC, Carey JC, Ernest JM, et al. (2006). Midpregnancy genitourinary tract infection with Chlamydia trachomatis: Association with subsequent preterm delivery in women with bacterial vaginosis and Trichomonas vaginalis. Am J Obstet Gynecol, 194:493-500. [Abstract]

Nansel TR, Riggs M, Yu KF, Andrews WW, Schwebke JR, & Klebanoff MA. (2006). The association of psychosocial stress and bacterial vaginosis in a longitudinal cohort. Am J Obstet Gynecol, 194:381-386. [Abstract]

Sheffield J, Andrews WW, Klebanoff MA, MacPherson C, Carey JC, Ernest JM,Wapner RJ, Trout W, Moawad A, Miodovnik M, Sibai B, Varner MW, Caritis SN, Dombrowski M, Langer O, O'Sullivan MJ, & Spong C. (2005). Spontaneous resolution of asymptomatic Chlamydia trachomatis in pregnancy. Obstet Gynecol, 105:557-562. [Abstract]

Goepfert A, Varner M, Ward K, MacPherson C, Klebanoff M, et al. (2005). Differences in inflammatory cytokine and Toll-like receptor genes and bacterial vaginosis in pregnancy. Am J Obstet Gynecol, 193:1478-1485. [Abstract]

Fiscella K & Klebanoff MA. (2004). Are racial differences in vaginal pH explained by vaginal flora? Am J Obstet Gynecol, 191(3):747-750. [Abstract]

Klebanoff MA, Hillier SL, Nugent RP, MacPherson CA, Hauth JC, Carey JC, et al. (2005). Is bacterial vaginosis a stronger risk factor for preterm birth when it is diagnosed earlier in gestation? Am J Obstet Gynecol, 192(2):470-477. [Abstract]

Klebanoff, MA, Schwebke JR, Zhang J, Nansel TR, Yu KF, & Andrews WW. (2004). Vulvovaginal symptoms in women with bacterial vaginosis. Obstet Gynecol, 104:267-272. [Abstract]

Klebanoff MA, Hauth JC, Carey, JC, MacPherson CA, et al. (2004). Time course of the regression of asymptomatic bacterial vaginosis in pregnancy with and without treatment. Am J Obstet Gynecol, 190:363-370. [Abstract]

Carey JC, Klebanoff MA, & National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. (2003). What have we learned about vaginal infections and preterm birth? Semin Perinatol, 27:212-216. [Abstract]

Hauth JC, MacPherson C, Carey JC, Klebanoff MA, Hillier SL, Ernest JM, et al. (2003). Early pregnancy threshold vaginal pH and Gram stain scores predictive of subsequent preterm birth in asymptomatic women. Am J Obstet Gynecol, 188:831-835. [Abstract]

Berghella V, Klebanoff M, MacPherson C, Carey JC, Hauth JC, Ernest JM, et al. (2002). Sexual intercourse association with asymptomatic bacterial vaginosis and Trichomonas vaginalis treatment in relation to preterm birth. Am J Obstet Gynecol, 187:1277-1282. [Abstract]

Goldenberg RL, Klebanoff M, Carey JC, & MacPherson C for the NICHD MFMU Network. (2001). Metronidazole treatment of women with a positive fetal fibronectin test result. Am J Obstet Gynecol, 185:485-486. [Abstract]

Carey JC & Klebanoff MA. (2001). Bacterial vaginosis and other asymptomatic vaginal infections in pregnancy. Cur Womens Health Rep, 1:31-35. [Abstract]

Klebanoff MA, Carey JC, Hauth JC, Hillier SL, Nugent RP, Thom EA, et al. (2001). Failure of metronidazole to prevent preterm delivery among pregnant women with asymptomatic Trichomonas vaginalis infection. N Engl J Med, 345:487-493. [Abstract]

Goldenberg RL, Klebanoff MA, Carey JC, Ernest J, Heine RP, MacPherson C, et al. (2000). Vaginal fetal fibronectin measurements from 8 to 22 weeks' gestation and subsequent spontaneous preterm birth. Am J Obstet Gynecol, 183:469-475. [Abstract]

Carey, JC, Klebanoff MA, Hauth JC, Hillier SL, Thom EA, Ernest JM, et al. (2000). Metronidazole to prevent preterm delivery in pregnant women with asymptomatic bacterial vaginosis. N Engl J Med, 342:534-540. [Abstract]