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Through the Microbial Looking Glass

Premature Labor, Preeclampsia, and Gestational Diabetes

A Scoping Review

Dunn, Alexis B., PhD, CNM; Hanson, Lisa, PhD, CNM, FACNM, FAAN; VandeVusse, Leona, PhD, RN, CNM, FACNM; Leslie, Sharon, MSLS, AHIP

The Journal of Perinatal & Neonatal Nursing: January/March 2019 - Volume 33 - Issue 1 - p 35–51
doi: 10.1097/JPN.0000000000000375
Feature Articles

The influence of microbial factors on adverse perinatal outcomes has become the focal point of recent investigations, with particular interest in the role of the microbiome and probiotic interventions. The purpose of this scoping review was to identify and critique the most recent evidence about these factors as they relate to pregnancies complicated by preeclampsia (PEC), preterm birth (PTB), and gestational diabetes mellitus (GDM). Four databases (PubMed, EMBASE, Web of Science, and Cochrane) were searched for articles published in English in the last 10 years with the concepts of the microbiome, probiotics, and PEC, PTB, or GDM. Forty-nine articles were eligible for full-text review. Five articles were excluded, leaving 44 articles that met all the eligibility criteria. The relationships between the microbiome and the risk for PEC, PTB, and GDM are not fully elucidated, although probiotic interventions seem beneficial in decreasing PEC and GDM risk. Probiotic interventions targeting bacterial vaginosis and elimination of infection in women at risk for PTB appear to be beneficial. More research is needed to understand the contributions of the microbiome to adverse perinatal outcomes. Probiotic interventions appear to be effective in reducing risk for select outcomes.

Nell Hodgson Woodruff School of Nursing at Emory University, Atlanta, Georgia (Dr Dunn); Nurse-Midwifery Program at the Marquette University College of Nursing, Milwaukee, Wisconsin (Dr Hanson); Marquette University College of Nursing, Milwaukee, Wisconsin (Dr VandeVusse); and Woodruff Health Sciences Center Library at Emory University, Atlanta, Georgia (Ms Leslie).

Corresponding Author: Alexis B. Dunn, PhD, CNM, Nell Hodgson Woodruff School of Nursing at Emory University, 1520 Clifton Rd NE, Atlanta GA 30322 (

Authors Hanson and VanderVusse are currently funded on a project from the National Institute of Child Health and Human Development of the National Institutes of Health (1R21HD095320-01). The content of this paper is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Each author has indicated that he or she has met the journal's requirements for Authorship.

Submitted for publication: August 16, 2018; accepted for publication: September 30, 2018.

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