Department of Obstetrics and Gynecology, University of Arizona, Tucson, AZ, USA.
Department of Obstetrics and Gynecology, University of Arizona, Tucson, AZ, USA.
Taiwan J Obstet Gynecol. 2024 Sep;63(5):610-613. doi: 10.1016/j.tjog.2024.06.002.
Worldwide, preterm birth (PTB) is a significant cause of neonatal mortality and morbidity. Surprisingly, the rate of PTB in the United States is among the top 10 nations in the world, comparable to those of the Democratic Republic of the Congo, Bangladesh, India, and Nigeria. However, there is no predictive biomarker or understanding of the mechanisms of PTB. Recent evidence suggests that the vaginal microbiome can be clustered into Community State Types (CST) and is altered in various obstetrical syndromes. The review aimed to summarize multiple studies on the vaginal microbiome and PTB and identify a particular microbe or CST associated with PTB. We hypothesized that there exists a specific microorganism that, when dominant within the vaginal microbiome, is protective against PTB. We hypothesized that the absence of a particular microbe or CST is a risk factor for PTB. To answer this question, we reviewed the current literature aiming to identify such a microorganism or a group of microorganisms. Our results indicate that no particular microbe or CST can be implicated in PTB. However, the review suggests that an increase in alpha and beta diversity of the vaginal microbiome can be predictive and involved in the pathogenesis of PTB.
全球范围内，早产（PTB）是新生儿死亡和发病的重要原因。令人惊讶的是，美国的早产率在世界上排名前十，与刚果民主共和国、孟加拉国、印度和尼日利亚相当。然而，目前还没有预测早产的生物标志物或对其机制的了解。最近的证据表明，阴道微生物组可以聚类为社区状态类型（CST），并在各种产科综合征中发生改变。本综述旨在总结关于阴道微生物组和早产的多项研究，并确定与早产相关的特定微生物或 CST。我们假设存在一种特定的微生物，当它在阴道微生物组中占主导地位时，可以预防早产。我们假设某种特定微生物或 CST 的缺失是早产的一个风险因素。为了回答这个问题，我们回顾了目前的文献，旨在确定这样一种微生物或一组微生物。我们的研究结果表明，没有特定的微生物或 CST 可以与早产相关。然而，综述表明阴道微生物组的 alpha 和 beta 多样性增加可以预测并参与早产的发病机制。
