Bacteria in faeces can cause premature babies

• EVE KAAMBO AND IYALOO KONSTANTINUS THE World Health Organisation defines preterm babies as babies born before 37 weeks gestational period. Preterm delivery is the leading cause of death among infants worldwide, with up to 50% occurring in pregnancies with no known risk factors.

Although preterm delivery (PTD) is a global problem, black women have been found to be more at risk of having a premature baby.

Different environmental factors such as socio-economic status, smoking, and alcohol and drug abuse have been attributed to PTD.

Scientific evidence has also attributed PTD to vaginal infections associated with micro-organisms such as bacterial vaginosis (BV) and aerobic vaginitis (AV).

BV is defined as an abnormal vaginal condition caused by overgrowth of atypical bacteria in the vagina. Women with BV during pregnancy are two to three times more likely to deliver preterm than women without BV. AV is caused by the overgrowth of aerobic pathogens including Escherichia coli, Group B Streptococcus, Staphylococcus aureus, and Enterococcus faecalis that trigger a localised vaginal inflammatory immunity response.

A study conducted by Eve Kaambo funded by the National Research Foundation (NRF) examined more than 300 women who attended antenatal clinics in the Western Cape to investigate the prevalence of AV and associated pregnancy outcomes.

A significant association was observed between PTD and specific bacteria species that are commonly found in faeces and have been implicated in AV. These bacteria may have been translocated from the anus to the vagina during wiping of the area from the back to the front during toiletry, thereby disrupting the balance of the normal bacteria of the vagina.

The most frequently found bacteria were Escherichia coli and Enterococcus faecalis normally found in the gastro-intestinal tract, and Streptococcus agalactiae commonly found in the vaginal-anal region. In this study, the multivariable analysis revealed that gravity, parity, infant weight, smoking, vaginal discharge, urinary tract infection, domestic violence and stress were significantly associated with PTD.

The results from this study provide improved guidelines for maternal screening.

The early detection of AV-related bacteria may significantly reduce maternal and neonatal morbidity.

An increased awareness of conditions such as AV, BV and sexually transmitted infections can alert mothers to their presence and prompt them to seek medical attention to reduce the risk of poor pregnancy outcomes. Mothers should be informed of the need to protect themselves from infection by adopting hygiene practices that will avoid the translocation of bacteria from the anal area.

Moreover, Namibia as a country would need to start investing in medical research to come up with screening tests to accurately identify women at risk.

* Eve Kaambo and Iyaloo Konstantinus are Namibian medical research scientists based at the Institute of Infectious Disease and Molecular Medicine at the University of Cape Town. For more information on our research focus, email us at eve.kaambo@yahoo.com or iyaloo.konstantinus@gmail.com