Vaginal Microbiota and Lubricant Use During Labor

Abstract

The human microbiome profoundly influences health promotion and disease prevention. Improved DNA and RNA sequencing technologies have enhanced our knowledge on the composition of the various microbial communities that constitute the microbiome. The structure and stability of the vaginal microbiota is of particular importance during pregnancy and labor because maternal microbes form the basis of the neonate’s own microbiome during the birth process. Vaginal dysbiosis, or perterbations in vaginal microbial composition, that occurs during labor can lead to suboptimal neonatal colonization and may be linked to adverse health outcomes for infants and children, including asthma and obesity. Vaginal dysbiosis is linked with many factors, including the use of personal lubricants. Studies using cell and animal models show that lubricants can alter microbial composition as well as damage the integrity of vaginal epithelial cells. These findings are concerning because similar lubricants are frequently used during labor. However, the effect of lubricant use on vaginal microbiota in the health-care setting has not been studied. This article presents current evidence on vaginal microbiota during pregnancy with a focus on the influence of a common practice, lubricant use during labor. Areas for future research are presented, as well as practice and policy implications for perinatal health-care providers.