Pediatric Grand Rounds (CME): Pregnancy, Gestational Outcome, and the Human Microbiome

Session Description:

Recent advances in the study of the human microbiota and their collective genomes have highlighted microbial diversity, features of individuality, conserved as well as personalized predicted functional attributes, and the intimate relationship of these communities to host physiology. Despite the critical role of the human microbiota in health, our understanding of the contributions of the maternal microbiota to fetal development and gestational outcome is incomplete. Preterm birth (PTB) is the leading cause of neonatal morbidity and mortality. Previous studies have suggested that the maternal vaginal microbiota contributes to the pathophysiology of PTB, but conflicting results in recent years have raised doubts. In two studies, based in part at Stanford, we have identified and confirmed features of the vaginal microbiota found early in pregnancy that are correlated with PTB. In addition, we have found evidence of a post-partum disturbance in the maternal microbiome that we are currently seeking to understand better, with possible implications for maternal health and future pregnancies. A predictive understanding of the microbiome and the mechanisms that underlie resilience will inform effective strategies for its manipulation, so as to maintain or restore health, and avoid or mitigate disease.

Education Goals:

• To appreciate the kinds of benefits that humans derive from their associations with microbes 
• To understand the possible role of the human microbiome in preterm birth
• To recognize the possible role of the human microbiome in future pregnancies
• To appreciate possible clinical interventions that might enhance the beneficial properties of the microbiome

CME Credit

Accreditation

The Stanford University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation

The Stanford University School of Medicine designates this live activity for a maximum of 1.00 AMA PRA Category 1 Credit(s)^TM.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Cultural and Linguistic Competency

California Assembly Bill 1195 requires continuing medical education activities with patient care components to include curriculum in the subjects of cultural and linguistic competency.  The planners and speakers of this CME activity have been encouraged to address cultural issues relevant to their topic area. The Stanford University School of Medicine Multicultural Health Portal also contains many useful cultural and linguistic competency tools including culture guides, language access information and pertinent state and federal laws. You are encouraged to visit the portal: http://lane.stanford.edu/portals/cultural.html