Ethnic variations in cervical cytokine concentrations and vaginal flora during pregnancy.

PROBLEM: Pregnancy-mediated changes in immunity may influence risk of HIV-1 acquisition. This risk appears greatest among non-Caucasian women.

METHOD OF STUDY: Pregnant women with low risk of immune disruption were enrolled in a prospective observational cohort. Study visits occurred each trimester and postpartum. Semi-quantitative vaginal cultures and concentrations of cervical cytokines were compared between Caucasian and non-Caucasian women.

RESULTS

In the second trimester, non-Caucasian women were more likely to be colonized with Gardnerella vaginalis (62% versus 25%, P = 0.02) and non-pigmented anaerobic gram-negative rods (43% versus 8%, P = 0.01). Mycoplasma hominis was more frequently isolated in non-Caucasian women throughout the second (29% versus 4%, P = 0.03) and third trimesters (35% versus 6%, P = 0.04). Non-Caucasian women had higher median interleukin (IL)-10 concentrations throughout the second (128 pg/mL versus 7 pg/mL, P = 0.05) and third trimesters (224 pg/mL versus 7 pg/mL, P = 0.05).

CONCLUSION

Non-Caucasian women experienced a greater diversity of microorganisms and increased IL-10 in the second and third trimesters.