Research Department, Sidra Medicine, Doha, Qatar.
Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Mae Sot, Thailand.
Front Cell Infect Microbiol. 2021 Mar 4;11:639665. doi: 10.3389/fcimb.2021.639665. eCollection 2021.
Preterm birth (PTB) is the most common cause of neonatal morbidity and mortality worldwide. Approximately half of PTBs is linked with microbial etiologies, including pathologic changes to the vaginal microbiota, which vary according to ethnicity. Globally more than 50% of PTBs occur in Asia, but studies of the vaginal microbiome and its association with pregnancy outcomes in Asian women are lacking. This study aimed to longitudinally analyzed the vaginal microbiome and cytokine environment of 18 Karen and Burman pregnant women who delivered preterm and 36 matched controls delivering at full term. Using 16S ribosomal RNA gene sequencing we identified a predictive vaginal microbiota signature for PTB that was detectable as early as the first trimester of pregnancy, characterized by higher levels of , and lower levels of , accompanied by decreased levels of cytokines including IFNγ, IL-4, and TNFα. Differences in the vaginal microbial diversity and local vaginal immune environment were associated with greater risk of preterm birth. Our findings highlight new opportunities to predict PTB in Asian women in low-resource settings who are at highest risk of adverse outcomes from unexpected PTB, as well as in Burman/Karen ethnic minority groups in high-resource regions.
早产 (PTB) 是全球新生儿发病率和死亡率的最常见原因。大约一半的 PTB 与微生物病因有关，包括阴道微生物群的病理变化，而这些变化因种族而异。全球超过 50%的 PTB 发生在亚洲，但亚洲女性阴道微生物组及其与妊娠结局的关联研究却很少。本研究旨在对 18 名早产的 Karen 和 Burman 孕妇和 36 名足月分娩的匹配对照组进行阴道微生物组和细胞因子环境的纵向分析。通过 16S 核糖体 RNA 基因测序，我们确定了一个可预测 PTB 的阴道微生物群特征签名，早在妊娠早期即可检测到，其特征是 水平升高， 水平降低，同时伴随 IFNγ、IL-4 和 TNFα 等细胞因子水平降低。阴道微生物多样性和局部阴道免疫环境的差异与早产的更高风险相关。我们的研究结果强调了在资源匮乏环境下的亚洲妇女中预测 PTB 的新机会，这些妇女面临着由于意外早产而导致不良结局的最高风险，同时也包括在资源丰富地区的 Burman/Karen 少数民族群体。
