Researchers at Johns Hopkins University received a grant from the Bill & Melinda Gates Foundation to investigate associations between the vaginal microbiome and preterm birth in rural Bangladesh. Alain Labrique, PhD, MHS, a professor in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health will lead the project. Collaborating institutions include icddr,b, the University of Maryland School of Medicine, and JiVitA, a large research project site in northwest rural Bangladesh with a population of over 650,000 people.
Women in Bangladesh, especially those living in rural areas, are significantly affected by Bacterial Vaginosis (BV), a disruption in the balance of vaginal bacterial communities that is associated with many adverse obstetric outcomes, from pregnancy loss to preterm birth and newborn deaths. Researchers will first examine the vaginal microbiome of pregnant women based on specimens collected as part of a 2001–2007 vitamin A, or β-carotene, supplementation trial in Bangladesh. This earlier trial followed the birth and development of the participants’ newborns up to three months of age and will allow researchers to explore the longitudinal relationship between birth outcomes and the vaginal microbiome of the mother.
Researchers will also conduct a pilot study to test sample collection and analysis methods for characterizing the vaginal microbiome among sexually active women of reproductive age in rural Bangladesh. Specifically, they will collect and analyze vaginal biospecimens from non-pregnant women and penile biospecimens from their male sexual partners from the JiVitA project site.
The long-term goal of the project is to inform development of novel interventions, such as vaginal probiotics, to prevent preterm birth and improve reproductive health. “Characterizing the vaginal microbiome among women in Bangladesh is a critical first step to the development of interventions to reduce risk for BV and adverse pregnancy outcomes,” says Labrique. “Our project aims to optimize vaginal and penile microbiome specimen collection and analysis through a unique, multi-disciplinary partnership of researchers in Baltimore and Bangladesh.”
Research findings will contribute to the Vaginal Microbiome Research Consortium (VMRC). The VMRC collects, analyzes, and shares data collected from pregnant and non-pregnant women across the globe in order to develop a framework for interventions to maintain and restore vaginal health for women worldwide.
"Women in Bangladesh, particularly those living in rural areas, are affected by extraordinarily high rates of preterm birth. Novel microbiome-based therapeutics such as probiotics hold promise to optimize the vaginal microbiota and prevent preterm birth and other poor reproductive outcomes,” says Susan Tuddenham, MD, a project co-investigator and an assistant professor in the Department of Medicine, Division of Infectious Diseases at the Johns Hopkins University School of Medicine. “Most development and testing of probiotics to date, however, has focused on U.S.-based populations, which may not be appropriate for women in other parts of the world. This project will build local research capacity and provide foundational data to inform the development of novel, urgently needed interventions to improve women's reproductive health in Bangladesh."
The Johns Hopkins University study team includes
- Alain Labrique
- Parul Christian
- Susan Tuddenham
- Daniel Erchick
- Subra Chakraborty
- Kelsey Alland
- Kerry Schulze
- Sarah Baker
- Lena Kan
- Kitty Stephenson
- Brian Dyer
- Lee Wu
- Khaled Hasan
