Abstract:
BACKGROUND : The vaginal microbiota (VMB) are the set of microorganisms residing in the human vagina. During
pregnancy, their composition is Lactobacillus-dominant in most Caucasian women. Previous studies suggest that
the VMB of women with African ancestry is more likely to be non-Lactobacillus dominant (dysbiotic) compared to
other populations, and possibly relate to the high incidence of pregnancy complications, such as preterm birth. This
work reviewed the literature on VMB composition in pregnant women from sub-Saharan Africa.
METHODS : A search was conducted in PubMed and Embase databases following PRISMA guidelines. Observational
and intervention studies analysing VMB communities from sub-Saharan African pregnant women using molecular
techniques were included.
RESULTS : Ten studies performed in seven sub-Saharan African countries were identified. They independently showed
that Lactobacillus-dominant VMB (particularly L. iners or L. crispatus) or VMB containing Lactobacilli are the most
prevalent, followed by a more diverse anaerobe-dominant VMB, in the studied populations. The majority of
pregnant women with a sexually-transmitted infection had a Lactobacillus-dominant VMB, but with a significantly
higher presence of anaerobic species.
CONCLUSION : In agreement with studies performed in other populations, Lactobacillus species are the most
prevalent VMB species during pregnancy in sub-Saharan African women. The frequency of diverse anaerobedominant
VMB is high in these populations. In Africa, studies on VMB in pregnancy are scant, heterogeneous in
methodology, and knowledge remains limited. More insights on VMB composition and their possible sequalae
among these populations is needed.
