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Sci."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Pregnant women in sub-Saharan Africa have high rates of maternal morbidity. There is interest in the impact of the vaginal microbiome on maternal health, including HIV and sexually transmitted infection (STI) acquisition. We characterized the vaginal microbiota of South African women \u2265 18 years with and without HIV in a longitudinal cohort over two visits during pregnancy and one visit postpartum. At each visit, we obtained HIV testing and self-collected vaginal swabs for point-of-care testing for STIs and microbiota sequencing. We categorized microbial communities and evaluated changes over pregnancy and associations with HIV status and STI diagnosis. Across 242 women (mean age 29, 44% living with HIV, 33% diagnosed with STIs), we identified four main community state types (CSTs): two lactobacillus-dominant CSTs (dominated by\n                    <jats:italic>Lactobacillus crispatus<\/jats:italic>\n                    and\n                    <jats:italic>Lactobacillus iners<\/jats:italic>\n                    respectively) and two diverse, non-lactobacillus-dominant CSTs (one dominated by\n                    <jats:italic>Gardnerella vaginalis<\/jats:italic>\n                    and one by diverse facultative anaerobes). From the first antenatal visit to the third trimester (24\u201336 weeks gestation), 60% of women in the\n                    <jats:italic>Gardnerella<\/jats:italic>\n                    -dominant CST shifted to lactobacillus-dominant CSTs. From the third trimester to postpartum (mean 17 days post-delivery), 80% of women in lactobacillus-dominant CSTs shifted to non-lactobacillus-dominant CSTs with a large proportion in the facultative anaerobe-dominant CST. Microbial composition differed by STI diagnosis (PERMANOVA\n                    <jats:italic>R<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    = 0.002,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.004), and women diagnosed with an STI were more likely to be categorized as\u00a0\n                    <jats:italic>L. iners<\/jats:italic>\n                    -dominant or\n                    <jats:italic>Gardnerella<\/jats:italic>\n                    -dominant CSTs. Overall, we found a shift toward lactobacillus dominance during pregnancy and the emergence of a distinct, highly diverse anaerobe-dominant microbiota profile in the postpartum period.\n                  <\/jats:p>","DOI":"10.1007\/s43032-023-01351-4","type":"journal-article","created":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T10:02:20Z","timestamp":1695031340000},"page":"275-287","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Changes in the Vaginal Microbiome During Pregnancy and the Postpartum Period in South African Women: a Longitudinal Study"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1201-7630","authenticated-orcid":false,"given":"Katherine T","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Jaspan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothy","family":"Nyemba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Landon","family":"Myer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Aldrovandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dvora","family":"Joseph-Davey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,9,18]]},"reference":[{"key":"1351_CR1","unstructured":"UNICEF. 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Ethical approval and oversight were obtained from the Faculty of Health Sciences Human Research Ethics Committee at the University of Cape Town (#454\/2017) and the University of California Los Angeles (#19\u2013000237). All experiments were performed in accordance with the Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics Approval"}},{"value":"Written informed consent was obtained from all participants before enrollment. Study data were collected and managed using Research Electronic Data Capture (REDCap). All study data used a unique participant identifier allocated at study enrolment, and all electronic communications were done through password-protected, encrypted files.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}},{"value":"All participants provided informed consent for the publication of de-identified data.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The authors declare no competing interests.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}