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Towards microbiome-informed strategies for predicting and preventing pregnancy complications
G L Ruschman1, J A Bittor1, D S Charnock-Jones1,2
1Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK.
Reproduction & Fertility
|June 10, 2026
Summary
Pregnancy complications lack predictive tools, but the microbiome offers promise. Research is exploring host-microbiome interactions for novel biomarkers and therapies to improve maternal and infant health outcomes.
Area of Science:
- Reproductive biology
- Microbiome research
- Maternal-fetal medicine
Background:
- Pregnancy complications like preeclampsia (PE), preterm birth (PTB), and fetal growth restriction (FGR) are prevalent, yet predictive tools are limited.
- The maternal microbiome is increasingly recognized for its role in regulating host physiology and its association with adverse pregnancy outcomes.
- Current understanding is largely correlative, based on taxonomic data, with limited insight into functional changes and underlying mechanisms.
Purpose of the Study:
- To review the current evidence on host-microbiome interactions during pregnancy.
- To explore potential molecular biomarkers and mechanistic insights for predicting and managing pregnancy complications.
- To discuss strategies for harnessing microbiome research for clinical applications to improve pregnancy outcomes.
Main Methods:
- Literature review integrating current evidence on host-microbiome interactions in pregnancy.
- Critical evaluation of methodologies and databases for studying microbial variation in pregnancy disorders.
- Exploration of direct and indirect mediators of host-microbiome interactions.
Main Results:
- Maternal physiological changes (immune, hormonal) influence microbiome composition and function.
- The microbiome modulates maternal immune, neuroendocrine, metabolic, and nutrient bioavailability pathways.
- Host-microbiome interactions significantly impact placental development and overall pregnancy physiology.
Conclusions:
- Targeting host-microbiome interactions offers potential for novel predictive biomarkers and therapeutic interventions for pregnancy complications.
- Understanding the microbiome's functional capacity, beyond taxonomy, is crucial for mechanistic insights.
- Further research integrating diverse methodologies is needed to translate microbiome findings into clinical applications for improved maternal and lifelong health.
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