Jefferson Kimberly K
Department of Microbiology and Immunology, Virginia Commonwealth University, Richmond, Virginia, USA.
Adv Appl Microbiol. 2012;80:1-22. doi: 10.1016/B978-0-12-394381-1.00001-5.
Preterm birth is the leading cause of infant morbidity and mortality. Very preterm births, those occurring before 32 completed weeks of gestation, are associated with the greatest risks. The leading cause of very preterm birth is intrauterine infection, which can lead to an inflammatory response that triggers labor or preterm premature rupture of membranes. How bacteria invade the uterine cavity, which is normally a sterile environment, and the reasons why different species vary in their capacity to induce inflammation and preterm birth are still incompletely understood. However, advanced techniques that circumvent the need for cultivating bacteria, deep sequence analysis that allows for the comprehensive characterization of the microbiome of a given body site and detection of low-prevalence species, and transcriptomics and metabolomics approaches that shed light on the host response to bacterial invasion are all providing a more complete picture of the progression from vaginal colonization to uterine invasion to preterm labor and preterm birth.
早产是婴儿发病和死亡的主要原因。极早产，即发生在妊娠满32周之前的早产，风险最大。极早产的主要原因是宫内感染，这会引发炎症反应，从而触发分娩或胎膜早破。细菌如何侵入通常无菌的子宫腔，以及不同物种在诱发炎症和早产能力上存在差异的原因，目前仍未完全明了。然而，无需培养细菌的先进技术、能够全面表征特定身体部位微生物组并检测低丰度物种的深度序列分析，以及揭示宿主对细菌入侵反应的转录组学和代谢组学方法，都正在为从阴道定植到子宫入侵再到早产和分娩的过程提供更完整的图景。
