Relationship between vitamin D status and the vaginal microbiome during pregnancy.

Kimberly K Jefferson, Hardik I Parikh, Erin M Garcia, David J Edwards, Myrna G Serrano, Martin Hewison, Judith R Shary, Anna M Powell, Bruce W Hollis, Jennifer M Fettweis, Jerome F Strauss Iii, Gregory A Buck, Carol L Wagner

Journal: Journal of perinatology : official journal of the California Perinatal Association 2020;39(6):824-836

PMID: 30858609

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Plain Language Summary

The composition of the vaginal microflora can significantly impact both reproductive and neonatal health. Numerous studies support the important role for sufficient serum or plasma concentrations of 25-hydroxy vitamin D (25(OH)D) during pregnancy in preventing negative outcomes. The study’s hypothesis was that vitamin D status is associated with the vaginal microbiome. This study is an analysis of a sub-cohort from a randomised, placebo-controlled clinical trial of vitamin D supplementation of pregnant women who were enrolled during the first trimester of pregnancy and followed until delivery. Participants (n=387) were randomised and received supplement: 191 received 400 IU (control group) and 196 received 4400 IU (treatment group). Results show that women in both the control and treatment groups displayed higher circulating 25(OH)D concentrations with increasing gestational age. Furthermore, among women of African ancestry, there was a negative correlation between 25(OH)D and abundance of Megasphaera [type of anaerobic microflora]. Authors conclude that certain vaginal bacteria are associated with plasma 25(OH)D concentration.

Abstract

OBJECTIVE

Evidence supports an inverse association between vitamin D and bacterial vaginosis (BV) during pregnancy. Furthermore, both the vaginal microbiome and vitamin D status correlate with pregnancy outcome. Women of African ancestry are more likely to experience BV, to be vitamin D deficient, and to have certain pregnancy complications. We investigated the association between vitamin D status and the vaginal microbiome.

STUDY DESIGN

Subjects were assigned to a treatment (4400 IU) or a control group (400 IU vitamin D daily), sampled three times during pregnancy, and vaginal 16S rRNA gene taxonomic profiles and plasma 25-hydroxyvitamin D [25(OH)D] concentrations were examined.

RESULT

Gestational age and ethnicity were significantly associated with the microbiome. Megasphaera correlated negatively (p = 0.0187) with 25(OH)D among women of African ancestry. Among controls, women of European ancestry exhibited a positive correlation between plasma 25(OH)D and L. crispatus abundance.

CONCLUSION

Certain vaginal bacteria are associated with plasma 25(OH)D concentration.

Address: Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, VA, USA.; Center for the Study of Biological Complexity, Virginia Commonwealth University, Richmond, VA, USA.; Department of Statistical Sciences and Operations Research, Virginia Commonwealth University, Richmond, VA, USA.; Institute of Metabolism and Systems Research, University of Birmingham, Edgbaston, Birmingham, UK.; Division of Neonatology, Shawn Jenkins Children's Hospital, Medical University of South Carolina Children's Hospital, Charleston, SC, USA.; Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA.; Department of Obstetrics and Gynecology, Virginia Commonwealth University, Richmond, VA, USA.; Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, VA, USA. [email protected].; Division of Neonatology, Shawn Jenkins Children's Hospital, Medical University of South Carolina Children's Hospital, Charleston, SC, USA. [email protected].

DOI: 10.1038/s41372-019-0343-8