Optimizing Maternal Microbiome: Role in Improved Conception and Pregnancy Outcome.

Area of Science:

• Reproductive Health
• Microbiome Research
• Maternal-Fetal Medicine

Background:

• The maternal microbiome plays a critical role in fertility and pregnancy success.
• Microbial dysbiosis is associated with adverse pregnancy outcomes and increased susceptibility to infections.

Purpose of the Study:

• To assess the impact of optimizing the maternal microbiome on pregnancy outcomes.
• To propose diagnostic and preventive strategies for preconception and early gestation, with a focus on low- and middle-income countries (LMICs).

Main Methods:

• A comprehensive literature review analyzed the influence of various body site microbiomes (vaginal, endometrial, gastrointestinal, urinary, oral) on fertility and pregnancy.
• Evaluated diagnostic methods (cultures, gene sequencing) and preventive interventions (nutrition, probiotics, vaccinations).

Main Results:

• An optimized microbiome, characterized by *Lactobacillus crispatus* dominance, enhances fertility and lowers risks of miscarriage, preterm birth, and congenital infections.
• Microbial dysbiosis, linked to lifestyle factors, increases risks. Preconception screening and targeted treatments improve outcomes.
• Nutritional interventions and supplements support microbial health. LMICs face significant challenges in accessing care and nutrition.

Conclusions:

• Preconception microbiome optimization via diagnostics, lifestyle modifications, and targeted therapies significantly enhances pregnancy outcomes.
• Implementing simple, cost-effective measures is vital for reducing maternal and fetal morbidity and mortality, particularly in LMICs.