Objective: With a global incidence of more than 10%, preterm birth (PTB) remains a significant concern. The vaginal microbiome strongly influences the well-being of the female reproductive tract. This study examines the correlation between changes in Lactobacillus vaginal microbiota and the PTB risk. Materials and Methods: A thorough search of PubMed, Web of Science, Cochrane Library, and EMBASE was conducted to locate studies that examined the association between changes in Lactobacillus vaginal microbiota and the risk of PTB from January 1, 2010, to January 30, 2023. The risk of PTB was determined by calculating odds ratios (ORs) with 95% confidence intervals (CIs). Results: In our analysis, there were 11 studies with 1577 pregnant women. The findings revealed a significant negative correlation between higher Lactobacillus abundance and the PTB risk (OR = 0.49, 95% CI: 0.29-0.84, p = 0.009 < 0.05). Similarly, the four individual dominant species, Lactobacillus crispatus (OR = 0.3, 95% CI: 0.14-0.67, p = 0.003 < 0.05), Lactobacillus gasseri (OR = 0.34, 95% CI: 0.17-0.69, p = 0.003 < 0.05), Lactobacillus iners (OR = 0.68, 95% CI: 0.49-0.93, p = 0.016 < 0.05), and Lactobacillus jensenii (OR = 0.43, 95% CI: 0.21-0.89, p = 0.024 < 0.05), were also negatively associated with the PTB risk. The risk of Lactobacillus for PTB was significant in both America (OR = 0.67; 95% CI: 0.50-0.92) and Asia (OR = 0.20; 95% CI: 0.09-0.47), whereas no significant risk was found in Europe (OR = 0.49; 95% CI: 0.11-2.15). Conclusions: Our study demonstrated that the abundance of Lactobacillus and the four dominant individual species (L. crispatus, L. jensenii, L. iners, and L. gasseri) were significantly and negatively associated with the PTB risk.

Cytolytic vaginosis (CV) is a little-known, controversial condition that is typically not considered for women presenting with vulvovaginitis symptoms. Objective: The objective of this scoping review was to identify and compile the global evidence on CV.
A medical librarian searched Prospero, Wiley Cochrane Library, Ovid Embase, Ovid Medline, EBSCO CINAHL, ProQuest Dissertations and Theses Global, and Scopus, from inception to April 4, 2019 and updated to October 17, 2021. Studies were eligible if they discussed CV. Two independent reviewers conducted study selection and data extraction.
Sixty-four studies were identified, with 67% of studies (n = 43) published since 2007. Studies were from around the world, including the United States (28%, n = 18), Brazil (11%, n = 7), Portugal (11%, n = 7), and China (11%, n = 7). Fifty percent of studies (n = 32) were reviews; the remainder were observational; and of these, 78% (n = 25) were cross-sectional. The most frequent topics included: diagnosis (19%, n = 12), prevalence (17%, n = 11), and overview of CV (50%, n = 32). Evidence for prevalence in symptomatic women (median prevalence of 5%, interquartile range 3%-8%) was based only on 16% of studies (n = 10) with minimal evidence on prevalence in asymptomatic women and across different geographic regions. Microbiological findings, including abundant lactobacilli and fragmented epithelial cells, were found useful to distinguish between CV and vulvovaginal candidiasis, and Lactobacillus crispatus was noted to dominate the vaginal flora in women with CV. Most studies used subjective criteria to diagnose CV as the condition lacks gold-standard microscopic criteria. The suggested primary treatment (baking soda irrigations) was largely based on expert opinion, and there was minimal evidence on associations between CV and other conditions.
Knowledge gaps currently exist in all realms of CV research. Additional research is needed to confirm the validity of CV and ensure that women are diagnosed and treated effectively.

Preterm birth is a major cause of neonatal morbidity and mortality worldwide. Increasing evidence links the vaginal microbiome to the risk of spontaneous preterm labour that leads to preterm birth. The aim of this systematic review and network meta-analysis was to investigate the association between the vaginal microbiome, defined as community state types (CSTs, i.e. dominance of specific lactobacilli spp, or not (low-lactobacilli)), and the risk of preterm birth. Systematic review using PubMed, Web of Science, Embase and Cochrane library was performed. Longitudinal studies using culture-independent methods categorizing the vaginal microbiome in at least three different CSTs to assess the risk of preterm birth were included. A (network) meta-analysis was conducted, presenting pooled odds ratios (OR) and 95% confidence intervals (CI); and weighted proportions and 95% CI. All 17 studies were published between 2014 and 2021 and included 38-539 pregnancies and 8-107 preterm births. Women presenting with \"low-lactobacilli\" vaginal microbiome were at increased risk (OR 1.69, 95% CI 1.15-2.49) for delivering preterm compared to Lactobacillus crispatus dominant women. Our network meta-analysis supports the microbiome being predictive of preterm birth, where low abundance of lactobacilli is associated with the highest risk, and L. crispatus dominance the lowest.

Accumulating evidence indicates the potential correlation between the vaginal microbioma and the acquisition and persistence of human papillomavirus (HPV) infection. This study aims to demonstrate the potential relationship through a systematic review of the current literature. A search was conducted on the following medical databases: PubMed and Scopus. Nineteen studies met the inclusion criteria and were incorporated in the present review. A total of 12.204 patients and their demographic characteristics were studied. Commercially available DNA tests and polymerase chain reaction (PCR) were used for the detection of different HPV subtypes, while the identification of the microbiomes was performed through specific diagnostic methods and PCR assay. The most frequently encountered species were classified based on their protective or detrimental impact on the progression of HPV infection. The beneficial role of some types of Lactobacillus (Lactobacillus gasseri, Lactobacillus jensenii, Lactobacillus crispatus) is generally supported. On the other hand, high microbial diversity and specific microorganisms such as Sneathia, Anaerococcus tetradius, Peptostreptococcus, Fusobacterium and Gardnerella vaginalis were found to be implicated with higher frequency and severity of disease, potentially resulting in pre-cancerous and cancerous cervical lesions.The role of vaginal microbiota appears to play an as yet not fully understood role in the susceptibility to HPV infection and its natural history.