{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:20:06Z","timestamp":1789226406872,"version":"build-2803163510"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T00:00:00Z","timestamp":1608681600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R21AI129712"],"award-info":[{"award-number":["R21AI129712"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["K23HD071788"],"award-info":[{"award-number":["K23HD071788"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Washington Royalty Research Fund","award":["A106982"],"award-info":[{"award-number":["A106982"]}]},{"name":"University of Washington Royalty Research Fund","award":["T32\u00a0AI07140"],"award-info":[{"award-number":["T32\u00a0AI07140"]}]},{"name":"University of Washington Royalty Research Fund","award":["AI027757"],"award-info":[{"award-number":["AI027757"]}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002319"],"award-info":[{"award-number":["UL1 TR002319"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["KL2 TR002317"],"award-info":[{"award-number":["KL2 TR002317"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1 TR002318"],"award-info":[{"award-number":["TL1 TR002318"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The vaginal microbiome plays a key role in women\u2019s reproductive health. Use of exogenous hormones, such as intramuscular depot medroxyprogesterone acetate (DMPA-IM), may alter the composition of vaginal bacterial community.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Vaginal swab samples were collected from postpartum Kenyan women initiating DMPA-IM or nonhormonal contraception (non-HC). Bacterial vaginosis was assessed by Nugent score (Nugent-BV) and bacterial community composition was evaluated using broad-range 16S ribosomal RNA gene polymerase chain reaction with high-throughput sequencing. Changes in Nugent score, alpha diversity (Shannon diversity index), and total bacterial load between contraceptive groups from enrollment to 3 months after initiation were estimated using multivariable linear mixed effects regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 54 human immunodeficiency virus\u2013negative women, 33 choosing DMPA-IM and 21 choosing non-HC, Nugent-BV was more common among DMPA-IM users at enrollment. At follow-up, Nugent score had decreased significantly among DMPA-IM users (change, \u22121.89; 95% confidence interval [CI], \u22123.53 to \u2212.25; P\u2005=\u2005.02) while alpha diversity remained stable (0.03; \u2212.24 to .30; P\u2005=\u2005.83). Conversely, Nugent score remained relatively stable among non-HC users (change, \u22120.73; 95% CI, \u22122.18 to .73; P\u2005=\u2005.33) while alpha diversity decreased (\u22120.34; \u2212.67 to \u2212.001; P\u2005=\u2005.05). The total bacterial load decreased slightly in DMPA-IM users and increased slightly among non-HC users, resulting in a significant difference in change between the contraceptive groups (difference, \u22120.64 log10 gene copies per swab sample; 95% CI, \u22121.19 to \u2212.08; P\u2005=\u2005.02). While significant changes in Nugent score and alpha diversity were observed within contraceptive groups, changes between groups were not significantly different.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Postpartum vaginal bacterial diversity did not change in DMPA-IM users despite a reduction in Nugent-BV, but it decreased significantly among women using non-HC. Choice of contraception may influence Lactobacillus recovery in postpartum women.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciaa1876","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T21:17:08Z","timestamp":1608585428000},"page":"e1093-e1102","source":"Crossref","is-referenced-by-count":8,"title":["Influence of Intramuscular Depot Medroxyprogesterone Acetate Initiation on Vaginal Microbiota in the Postpartum Period"],"prefix":"10.1093","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3738-5704","authenticated-orcid":false,"given":"Bridget M","family":"Whitney","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sujatha","family":"Srinivasan","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Tapia","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, Seattle, Washington, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric Munene","family":"Muriuki","sequence":"additional","affiliation":[{"name":"Institute of Infectious and Tropical Diseases (UNITID), University of Nairobi, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavna H","family":"Chohan","sequence":"additional","affiliation":[{"name":"Department of Global Health, University of Washington, and Kenya Medical Research Institute, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline M","family":"Wallis","sequence":"additional","affiliation":[{"name":"Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, 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