The gynecological health of the woman passes through the vaginal microbiome and the immune system which are in close connection with each other. The microbiome, in all stages of life, affects the life, health, and even the mood of women. As demonstrated by numerous publications, in addition to the intestinal microbiome there is a vaginal microbiome, called vaginoma, which is different in each ethnic group, made up of different strains of microorganisms. In conception, pregnancy and the puerperium it is essential that the vaginal microbiome is healthy, stable and in balance, because it contributes to the prevention of pathologies of pregnancy, to the health and well-being of the fetus and then of the child, at every stage of its growth. We talked about it with Dr. Franco Vicariotto, gynecologist of Humanitas San Pio X and member of the scientific board of the IPA (International Probiotic Association).
What is the role of the vaginal microbiome in pregnancy and conception?
“During pregnancy, and even before conception, when it comes to the vaginal microbiome, not only the presence or absence of dysbiosis (imbalance) or eubiosis (balance) is important, but above all it is important that there is a prevalence of certain microbial strains such as lactobacilli, which induce the necessary stability of the vaginal microbiome in pregnancy.This, for example, is particularly important in conception, where it has been seen that there is an altered (pathological) vaginal microbial pattern in women suffering from idiopathic infertility, i.e. when there is no causes of infertility are found.
There are five different types of vaginal microbiome recognized, each with a predominant microbial strain compared to the others, which is also expressed in terms of women’s health: for example, women with type I vaginal microbiome (one) have a prevalence of lactobacilli, important for conception and healthy pregnancy, while when the vaginal microbiota is type IV (four), i.e. there is no predominant strain, women are generally more exposed to the risk of vaginal infections or dysbiosis and vaginosis which, as we now know, can contribute to the development of pregnancy complications . During pregnancy, in fact, together with the many changes that this period brings with it, the intestinal bacterial load also changes in order to promote greater stability of the microbiome, increase the prevalence of lactobacilli, thus providing greater defense against any aggression from pathogens. After all, in physiological pregnancy, the body and the woman’s immune system change to guarantee and protect the life of the fetus”.
How is the vaginal microbiome stable during pregnancy?
“To keep the vaginal microbiome stable, during pregnancy the production of estrogen increases, the hormones that stimulate the production of glycogen which, in turn, transforms into lactobacilli, the microorganisms prevalent in the vaginal microbiome in healthy pregnancy. This transformation contributes to reduce microbial diversity in the vaginal microbiome in order to defend the vaginal ecosystem in pregnancy and increase the stability of vaginal conditions, including pH. However, the conditions are not always such as to induce stability and reduction of diversity in the vaginal microbiome. And when does not happen, the risk of developing pathologies of pregnancy and bacterial vaginosis increases, conditions that increase the probability of preterm birth, the most common cause of fetal death.To keep the vaginal microbiome healthy and in balance, today, together with a correct diet before and during pregnancy, pregnancy-specific supplements may be prescribed, and probiotics in case of prevention of high-risk pregnancies”.