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Cervicovaginal microbiota and local immune response modulate the risk of spontaneous preterm delivery

Author

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  • Michal A. Elovitz

    (University of Pennsylvania)

  • Pawel Gajer

    (University of Maryland School of Medicine)

  • Valerie Riis

    (University of Pennsylvania)

  • Amy G. Brown

    (University of Pennsylvania)

  • Michael S. Humphrys

    (University of Maryland School of Medicine)

  • Johanna B. Holm

    (University of Maryland School of Medicine)

  • Jacques Ravel

    (University of Maryland School of Medicine)

Abstract

Failure to predict and understand the causes of preterm birth, the leading cause of neonatal morbidity and mortality, have limited effective interventions and therapeutics. From a cohort of 2000 pregnant women, we performed a nested case control study on 107 well-phenotyped cases of spontaneous preterm birth (sPTB) and 432 women delivering at term. Using innovative Bayesian modeling of cervicovaginal microbiota, seven bacterial taxa were significantly associated with increased risk of sPTB, with a stronger effect in African American women. However, higher vaginal levels of β-defensin-2 lowered the risk of sPTB associated with cervicovaginal microbiota in an ethnicity-dependent manner. Surprisingly, even in Lactobacillus spp. dominated cervicovaginal microbiota, low β-defensin-2 was associated with increased risk of sPTB. These findings hold promise for diagnostics to accurately identify women at risk for sPTB early in pregnancy. Therapeutic strategies could include immune modulators and microbiome-based therapeutics to reduce this significant health burden.

Suggested Citation

  • Michal A. Elovitz & Pawel Gajer & Valerie Riis & Amy G. Brown & Michael S. Humphrys & Johanna B. Holm & Jacques Ravel, 2019. "Cervicovaginal microbiota and local immune response modulate the risk of spontaneous preterm delivery," Nature Communications, Nature, vol. 10(1), pages 1-8, December.
    • Handle: RePEc:nat:natcom:v:10:y:2019:i:1:d:10.1038_s41467-019-09285-9
    DOI: 10.1038/s41467-019-09285-9
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    Cited by:

    1. Pamela Pruski & Gonçalo D. S. Correia & Holly V. Lewis & Katia Capuccini & Paolo Inglese & Denise Chan & Richard G. Brown & Lindsay Kindinger & Yun S. Lee & Ann Smith & Julian Marchesi & Julie A. K. M, 2021. "Direct on-swab metabolic profiling of vaginal microbiome host interactions during pregnancy and preterm birth," Nature Communications, Nature, vol. 12(1), pages 1-14, December.
    2. Megan M. Shannon & Jane E. Clougherty & Clare McCarthy & Michal A. Elovitz & Max Jordan Nguemeni Tiako & Steven J. Melly & Heather H. Burris, 2020. "Neighborhood Violent Crime and Perceived Stress in Pregnancy," IJERPH, MDPI, vol. 17(15), pages 1-11, August.
    3. Denise Chan & Phillip R. Bennett & Yun S. Lee & Samit Kundu & T. G. Teoh & Malko Adan & Saqa Ahmed & Richard G. Brown & Anna L. David & Holly V. Lewis & Belen Gimeno-Molina & Jane E. Norman & Sarah J., 2022. "Microbial-driven preterm labour involves crosstalk between the innate and adaptive immune response," Nature Communications, Nature, vol. 13(1), pages 1-15, December.

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