Stephanno G P Sarmento1, Antonio F Moron2,3, Larry J Forney4, Alan R Hatanaka2, Francisco H C Carvalho5, Marcelo S França2, Tatiana K Hamamoto2, Rosiane Mattar2, Iara M Linhares6, Evelyn Minis7, Adriana Sañudo8, Ester Sabino3, Marilza V C Rudge9, Steven S Witkin7,10. 1. Department of Obstetrics and Gynecology, Federal University of Jundiaí, São Paulo, Brazil. 2. Department of Obstetrics, Federal University of São Paulo, São Paulo, Brazil. 3. Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil. 4. Department of Biological Sciences and the Institute for Bioinformatics and Evolutionary Studies, University of Idaho, Moscow, ID, USA. 5. Department of Obstetrics and Gynecology, Federal University of Ceará, Ceará, Brazil. 6. Department of Obstetrics and Gynecology, University of São Paulo Medical School, São Paulo, Brazil. 7. Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA. 8. Department of Preventive Medicine, Federal University of São Paulo, São Paulo, Brazil. 9. Department of Obstetrics and Gynecology, São Paulo State University Medical School, Botucatu, Brazil. 10. Virology Laboratory (LIM 52), Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil.
Abstract
BACKGROUND: Predictors of spontaneous preterm birth in primigravid women remain undetermined. AIM: We evaluated whether biomarkers in vaginal secretions and/or differences in the dominant bacterium in the vaginal microbiome predicted the risk for spontaneous preterm birth in primigravid women with a cervical length >25mm. STUDY DESIGN: In a prospective study, 146 second trimester pregnant women with their first conception and a cervix >25mm were enrolled. The vaginal microbiome composition was characterized by analysis of 16S ribosomal RNA gene sequences. The concentrations of d- and l-lactic acid, matrix metalloproteinase (MMP) 2, 8 and 9 and tissue inhibitor of metalloproteinase (TIMP) 1 and 2 in vaginal secretions were measured by ELISA. Cervical length was determined by vaginal ultrasonography. Pregnancy outcome data were subsequently collected. There was a spontaneous preterm birth (SPTB) in 13 women (8.9%) while in an additional 8 women (5.5%) preterm delivery was medically indicated. Lactobacillus iners was the dominant vaginal bacterium in 61.5% of women with a SPTB but only in 31.2% of those who delivered at term (p = .0354). The vaginal concentration of TIMP-1 (p = .0419) and L-lactic acid (p = .0495) was higher in women with a SPTB as compared to those who delivered at term. Lactobacillus iners dominance was associated with elevated levels of TIMP-1 (p = .0434) and TIMP-2 (p = .0161) and lower levels of D-lactic acid (p < .0001) compared to when L. crispatus was dominant. CONCLUSION: In this exploratory study of primigravid women, elevations in vaginal TIMP-1 and L- lactic acid and L. iners dominance in the vaginal microbiome are associated with an increased occurrence of SPTB.
BACKGROUND: Predictors of spontaneous preterm birth in primigravid women remain undetermined. AIM: We evaluated whether biomarkers in vaginal secretions and/or differences in the dominant bacterium in the vaginal microbiome predicted the risk for spontaneous preterm birth in primigravid women with a cervical length >25mm. STUDY DESIGN: In a prospective study, 146 second trimester pregnant women with their first conception and a cervix >25mm were enrolled. The vaginal microbiome composition was characterized by analysis of 16S ribosomal RNA gene sequences. The concentrations of d- and l-lactic acid, matrix metalloproteinase (MMP) 2, 8 and 9 and tissue inhibitor of metalloproteinase (TIMP) 1 and 2 in vaginal secretions were measured by ELISA. Cervical length was determined by vaginal ultrasonography. Pregnancy outcome data were subsequently collected. There was a spontaneous preterm birth (SPTB) in 13 women (8.9%) while in an additional 8 women (5.5%) preterm delivery was medically indicated. Lactobacillus iners was the dominant vaginal bacterium in 61.5% of women with a SPTB but only in 31.2% of those who delivered at term (p = .0354). The vaginal concentration of TIMP-1 (p = .0419) and L-lactic acid (p = .0495) was higher in women with a SPTB as compared to those who delivered at term. Lactobacillus iners dominance was associated with elevated levels of TIMP-1 (p = .0434) and TIMP-2 (p = .0161) and lower levels of D-lactic acid (p < .0001) compared to when L. crispatus was dominant. CONCLUSION: In this exploratory study of primigravid women, elevations in vaginal TIMP-1 and L- lactic acid and L. iners dominance in the vaginal microbiome are associated with an increased occurrence of SPTB.
Authors: Unnur Gudnadottir; Justine W Debelius; Juan Du; Luisa W Hugerth; Hanna Danielsson; Ina Schuppe-Koistinen; Emma Fransson; Nele Brusselaers Journal: Sci Rep Date: 2022-05-13 Impact factor: 4.996
Authors: Sarah E Brown; Courtney K Robinson; Michelle D Shardell; Johanna B Holm; Jacques Ravel; Khalil G Ghanem; Rebecca M Brotman Journal: Front Cell Infect Microbiol Date: 2021-06-29 Impact factor: 5.293