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THE ROLE OF THE VAGINAL MICROBIOTA IN THE PATHOGENESIS OF PRETERM PREMATURE BIRTH IN WOMEN WITH IC: A SYSTEMATIC

S Issenova1, K Bakytkhan1, B Malgazhdarova2

  • 11Department of Obstetrics and Gynecology with a Course in Clinical Genetics, NJSC "Kazakh National Medical University named after S.D. Asfendiyarov", Almaty, Republic of Kazakhstan.

Georgian Medical News
|July 22, 2025
PubMed

Insights

Vaginal microbial imbalance, specifically low Lactobacillus and high pathogenic bacteria, is linked to preterm birth in women with cervical insufficiency and prelabor rupture of membranes.

Area of Science:

  • Reproductive biology
  • Microbiome research
  • Obstetrics

Background:

  • Cervical insufficiency and vaginal microbiota imbalance are significant factors affecting preterm birth.
  • Understanding these factors is crucial for improving neonatal outcomes.

Purpose of the Study:

  • To investigate the role of vaginal microbiota in prelabor rupture of membranes (PROM) among women with cervical insufficiency.
  • To analyze microbial profiles, risk factors, biomarkers, management strategies, and neonatal outcomes.

Main Methods:

  • A systematic review of 13 English-language studies (2020-2025) was conducted.
  • Databases searched included ProQuest, Web of Science, Scopus, Cochrane Library, PubMed, and Google Scholar.
  • Bias was assessed using RoB 1 and ROBINS-I tools.

Main Results:

  • Lactobacillus depletion and increased pathogenic bacteria (e.g., Gardnerella, E. coli, Mycoplasma) characterize dysbiosis.
  • Risk factors for PROM include bacterial vaginosis, short cervix, and cervical insufficiency.
  • Preterm birth rates ranged from 8.9% to 84%, with neonatal complications like respiratory distress; however, fetal survival rates up to 93% were observed.

Conclusions:

  • Microbial dysbiosis in the context of cervical insufficiency is associated with adverse preterm birth outcomes.
  • Specific biomarkers like MMP-8 and inflammatory cytokines may indicate microbial imbalance.
Abstract

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