Dysbiosis of vaginal microbiota associated with increased risk of
preterm premature rupture of fetal membrane and chorioamnionitis in
singleton gestations with ultrasound-indicated cerclage
Abstract
Objective: To investigate dysbiosis of the vaginal microbiota related to
increased risk of preterm premature rupture of fetal membrane (PPROM)
and chorioamnionitis in singleton gestations with ultrasound-indicated
cerclage. Design: Retrospective observational study. Setting: Fujian
Maternity and Child Health Hospital. Population: 44 singleton gestations
with ultrasound-indicated cerclage, including 13 cases of PPROM and 31
cases of normal-term delivery. Methods: Composition of the vaginal
microbiota was assessed prior to cervical cerclage at 18–24 weeks of
gestation, using MiSeq-based 16S rRNA gene sequencing. Main Outcome
Measures: To characterize the vaginal microbial profile of women who
later experienced PPROM and chorioamnionitis. Results: Furthermore, the
vaginal microbiota of women who later experienced PPROM was relatively
enriched with Streptococcus anginosus and Prevotella timonensis
(P=0.042, P=0.032, respectively), while that of women who later
experienced normal-term delivery was relatively enriched with
Lactobacillus. Further, enrichment for Prevotella was noted in patients
diagnosed with chorioamnionitis in the PPROM group (6 of 13, 53.8%),
which was absent in women with normal histology in the PPROM group
(P=0.012). Conclusions: Together, these results indicate that dysbiosis
of the vaginal microbiota is a risk element for subsequent PPROM and
chorioamnionitis in singleton gestations with ultrasound-indicated
cerclage. These findings may contribute to the development of methods to
identify pregnancies at high risk for cerclage failure following PPROM.
Funding: This work was supported by a grant from the Fujian Maternity
and Child Health Hospital Innovation Project (YCXZ 18-21). Keywords:
Vaginal microbiota, PPROM, chorioamnionitis, ultrasound-indicated
cerclage, Prevotella.