TY - JOUR AU - Moron, Antonio Fernandes AU - Witkin, Steven Sol AU - Linhares, Iara Moreno AU - Hatanaka, Alan Roberto AU - Sarmento, Stéphanno Gomes Pereira AU - França, Marcelo Santucci AU - Carvalho, Francisco Herlânio Costa AU - Mattar, Rosiane AU - Forney, Larry Jay PY - 2022/05/19 Y2 - 2024/03/29 TI - Lactobacillus crispatus dominance in the vaginal microbiome reduces the occurrence of spontaneous preterm birth in women with a short cervical length JF - Brazilian Journal of Sexually Transmitted Diseases JA - DST VL - 34 IS - SE - Original Article DO - 10.5327/DST-2177-8264-20223407 UR - https://bjstd.org/revista/article/view/1198 SP - AB - <p>Introduction: The majority of pregnant women with a short cervix will deliver at term and, thus, may unnecessarily receive advanced monitoring and<br>treatment. It is still necessary to define more accurately which sub-population of women with a short cervix is at elevated risk for early delivery. Objective:<br>To determine if vaginal microbiome composition influenced the rate of spontaneous preterm birth in women with a short cervical length. Methods: In an<br>exploratory, observational prospective study, vaginal secretions were obtained from 591 women at 21–24 week gestation. Vaginal microbiome composition<br>was determined by analyzing the V1–V3 region of the bacterial 16S ribosomal RNA gene. Results: Lactobacillus crispatus was numerically dominant in<br>the vagina in 41.7% of subjects, followed by L. iners in 32% and Gardnerella vaginalis in 12%. In women whose cervix was ≤25mm, the sensitivity to<br>predict an spontaneous preterm birth was 11.8%. However, when L. crispatus was not the dominant vaginal bacterium, this sensitivity increased to 81.8%.<br>Similarly, in women with a cervical length ≤30mm, the sensitivity to predict an spontaneous preterm birth increased from 21.7 to 78.3% when L. crispatus<br>was not the dominant vaginal bacterium. In women with a prior spontaneous preterm birth and a cervix ≤25 or ≤30mm, L. crispatus dominance was also<br>associated with a reduced rate of spontaneous preterm birth in the current pregnancy (p&lt;0.001). Conclusion: In pregnant women with a cervix ≤25mm or<br>≤30mm, the risk for an spontaneous preterm birth is increased if L. crispatus is not dominant in the vagina.</p> ER -