The Vaginal Microbiota in Early Pregnancy Identifies a Subset of Women at Risk for Early Preterm Prelabor Rupture of Membranes and Preterm Birth

Author:

Romero RobertoORCID,Tarca Adi1ORCID,Gomez-Lopez Nardhy1ORCID,Winters Andrew2ORCID,Panzer Jonathan2,Lin Huang3,Gudicha Dereje1,Galaz Jose1ORCID,Farias-Jofre Marcelo1,Kracht David2,Chaiworapongsa Tinnakorn2,Jung Eunjung1,Gotsch Francesca1,Suksai Manaphat1ORCID,Berry Stanley1,Ravel Jacques4ORCID,Peddada Shyamal5ORCID,Theis Kevin2

Affiliation:

1. Wayne State University School of Medicine

2. Wayne State University

3. University of Pittsburgh

4. University of Maryland, Baltimore

5. Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health

Abstract

AbstractSpontaneous preterm birth (sPTB) can occur when vaginal bacteria gain access to the amniotic cavity. Thus, the predictive value of the vaginal microbiota for sPTB has been investigated, yet results have been inconclusive. Here, we report the largest study of the vaginal microbiota using longitudinal sampling of 257 cases and 514 controls (2,976 samples). Associations between the microbiota and sPTB were limited to cases of early (delivery <34 weeks) preterm prelabor rupture of membranes (PPROM). Starting with early gestation, microbial diversity was higher in early PPROM cases than controls, as were the relative abundances of Anaerococcus, Mobiluncus, Prevotella, and Sneathia. Random forest models based on data collected before 28 weeks predicted early PPROM [AUC=0.62(0.51−0.73)], while data collected by 24 weeks predicted PPROM with delivery <30 weeks [AUC=0.68(0.53-0.84)]. Therefore, monitoring of the vaginal microbiota profile may have clinical utility to identify a subset of women who will deliver a preterm neonate.

Publisher

Research Square Platform LLC

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