The Microbiome of the Female Reproductive Tract and Pregnancy
Gregory A. Buck and the Vaginal Microbiome Consortium at VCU Department of Microbiology and Immunology and the Center for Microbiome Engineering and Data Analysis, Virginia Commonwealth University, Richmond, Virginia, USA The microbiome of the the human female reproductive tract is diverse and thought to have a significant impact on women's reproductive health, including but not limited to risk of preterm birth. Preterm birth has a prevalence of ~10%, although some demographic groups (e.g., African Americans) experience even higher incidence. The overall incidence of adverse outcomes in pregnancy and neonatal health has decreased in recent decades, but the risk of preterm birth has not shown commensurate changes. The annual cost of preterm birth in the United States is estimated at over $25 billion. Thus, preterm birth remains a serious issue and it is estimated that 40-50% of preterm birth involves a microbial etiology.
The Vaginal Human Microbiome Consortium at VCU has examined the microbiome profiles of over 6,000 women in a cross-sectional study, and, in collaboration with the Global Alliance to Prevent Preterm Birth and Prematurity, nearly 1600 pregnant women in a longitudinal study. We have collected and banked nearly a quarter million vaginal, rectal, buccal, blood, urine, skin and birth product samples for analysis by 16S taxonomic, metagenomic, metatranscriptomic and cytokine profiling. Analysis of a fraction of these samples has identified modifications in the microbiome during pregnancy, and these modifications vary among demographic groups. We also observed a correlation between microbiome compositions associated with preterm birth and have characterized the genomes of some of the relevant bacterial taxa. The results overall show promise to provide strategies for predicting risk of preterm birth to permit earlier intervention and monitoring to prevent this adverse outcome.
This work is supported by grants from the NIH Common Fund Human Microbiome Project (1UH2/UH3AI08326 and 8U54HD080784 to G. Buck, K. Jefferson and J. Strauss), the Global Alliance to Prevent Prematurity and Stillbirth (PPB Grant 15011), and NIH/NICHD (HD092415). We thank all the members of the Vaginal Microbiome Consortium at VCU (vmc.vcu.edu) for their contributions to this project, and the Global Alliance for the Prevention of Prematurity and Stillbirth (gapps.org) for their participation and support.