Outside of the setting of BV, an anti-inflammatory state of the mother's immune system has been shown to be associated with successful pregnancy outcome.6 Conversely, increased expression of proinflammatory cytokines such as TNF is usually associated with several APOs.18–21 Thus, our finding that the vaginal anti-inflammatory immune response to BV we observe may participate in pregnancy outcome in this setting. Here, TNF is linked to bacterial vaginosis.