Bacterial vaginosis (BV) is a significant cause of complications in pregnancy and can increase the likelihood of infection from a variety of sexually transmitted diseases, including HIV/AIDS. NICHD joins the National Institute of Allergy and Infectious Diseases and other NIH Institutes in advancing understanding of its causes as well as preventive measures and treatment. NICHD also plays an important role in educating both the public and health professionals about the effective diagnosis and treatment of BV.
As a part of its portfolio, NICHD supports and conducts research on four aspects of BV:
- Understanding and maximizing fertility. Because BV can potentially cause infertility, ongoing research on infertility supported by the NICHD's Contraception Research Branch provides valuable information on the health of women affected by BV.
- Ensuring healthful and safe contraception. A woman's risk of developing BV is increased by having unprotected sexual activity. The many research areas supported by the CRH Branch, including contraception, are important for obtaining a complete understanding of BV.
- Preventing preterm deliveries. NICHD's Maternal-Fetal Medicine Units (MFMU) Network has played a leading role in studying BV in pregnant women, especially those who are asymptomatic. A major focus of its studies has been the actual effects of antibiotics, especially clindamycin and metronidazole, in preventing preterm births in women with BV. MFMU researchers also conducted a study of maternal markers that could predict the likelihood of preterm delivery in pregnant women with BV.
- Combating HIV/AIDs and its effects on children. BV can increase a woman's risk of getting HIV/AIDS from an infected partner. Mother-to-child transmission is the major way that children are infected with HIV/AIDS. If a woman becomes HIV positive during pregnancy, her infant is at risk of becoming infected with HIV. For this reason, it is important to understand and take steps to control BV in pregnant women to help protect their unborn fetuses not only from the effects of BV but also from acquiring HIV/AIDS. Recent data suggest that BV may increase the risk of transmission of HIV from a woman to her fetus. NICHD researchers have conducted and supported a wealth of research on HIV/AIDS for nearly 25 years, especially through the NICHD Maternal and Pediatric Infectious Disease Branch (MPIDB).
The MPIDB also supports and conducts both domestic and international research into the epidemiology, natural history, pathogenesis, transmission, treatment, and prevention of HIV infection and its complications in infants, children, adolescents, pregnant women, mothers, women of childbearing age, and the family unit as a whole. These research areas are relevant to BV because BV increases a woman's likelihood of acquiring HIV/AIDS and passing HIV/AIDS on to a partner. In addition, because BV increases a woman's likelihood of acquiring HIV/AIDS, her fetus is at increased risk.
Institute Activities and Advances
Several NICHD organizational units support and conduct research on BV and the diseases and conditions that are affected by it, including HIV/AIDS. In addition, NICHD conducts research on areas relevant to BV such as infertility and contraception. A summary of some of these efforts follows.
Research supported by NICHD's Pregnancy and Perinatology Branch (PPB) has included studies of BV in pregnant women. Several of these studies have been conducted by researchers in the Maternal-Fetal Medicine Units (MFMU) Network, and scientists from the Division of Population Health Research. A major focus of the Network's research has been on the ability of antibiotics, including clindamycin and metronidazole, to prevent preterm birth in pregnant women who test positive for BV but have no symptoms. Other research supported by NICHD has included studies to identify maternal markers for predicting the likelihood of preterm delivery in pregnant women with BV.
NICHD's Maternal and Pediatric Infectious Disease Branch (MPIDB) supports and conducts both domestic and international research into the epidemiology, natural history, pathogenesis, transmission, treatment, and prevention of HIV infection and its complications in infants, children, adolescents, pregnant women, mothers, women of childbearing age, and the family unit as a whole. These research areas are relevant to BV because BV increases a woman's likelihood of acquiring HIV/AIDS and passing HIV/AIDS on to a partner. In addition, because BV increases a woman's likelihood of acquiring HIV/AIDS, her fetus is at increased risk.
NICHD's Contraception Research Branch (CRB) supports and conducts research and research training programs on reproductive health, epidemiology, and contraceptive technology. Major research areas include studies of new contraceptive methods; mechanisms of action and effects of contraceptive and reproductive hormones, drugs, devices, and procedures; optimal formulations and dosages of contraceptive agents, spermicidal microbicides, and hormone replacement therapies; post-marketing surveillance of reproductive products, devices, and procedures; and the health and fertility effects of reproductive drugs, devices, and procedures.
A woman's risk of developing BV is increased by having unprotected sexual activity. The many research areas supported by the CRB, including contraception, are important for acquiring a complete understanding of BV. In addition, because BV can potentially increase the risk of co-infections that cause infertility, Branch-supported research on that topic provides valuable information on the health of women affected by BV.
Other Activities and Advances
The MMFMU Network, which is supported by the NICHD PPB, conducts studies of maternal and fetal medicine and obstetrics, with emphasis on the continuing problem of preterm birth. The Network has conducted clinical studies related to numerous areas of research, such as maternal health; fetal health and development; gestational diabetes, asthma, and thyroid disorders; and preterm labor.
Some of the studies conducted by MFMU Network researchers are directly relevant to the understanding of BV in pregnant women, particularly those who are asymptomatic. Among other topics, researchers have examined the efficacy of antibiotics for preventing preterm birth in pregnant women and the use of markers to predict preterm delivery.
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