Abstract

Microbial infection of the placenta, amniotic fluid, vaginal canal, and oral cavity is known to significantly contribute to preterm birth (PTB). Although microbes can be translocated into the blood, little is known regarding the blood microbiota during pregnancy. To assess changes in the microbiome during pregnancy, blood samples were obtained 2 or 3 times during pregnancy from a cohort of 45 pregnant women enrolled between 2008 and 2010. To analyze the association with PTB, we conducted a case-control study involving 41 pregnant women upon admission for preterm labor and rupture of membrane (20 with term delivery; 21 with PTB). Bacterial diversity was assessed in number and composition between the first, second, and third trimesters in term delivered women according to 16S rRNA gene amplicon sequencing, and data were analyzed using Quantitative Insight Into Microbial Ecology (QIIME). Taxonomy was assigned using the GreenGenes 8.15.13 database. Dominant microorganisms at the phylum level in all pregnant women were identified as Firmicutes, Proteobacteria, Bacteroidetes, and Actinobacteria. However, the number and composition of bacteria in women with PTB differed from that in women with term delivery. Firmicutes and Bacteroidetes were more abundant in women with PTB than in women with term delivery, while Proteobacteria was less prevalent in women with PTB. At the genus level, Bacteroides, Lactobacillus, Sphingomonas, Fastidiosipila, Weissella, and Butyricicoccus were enriched in PTB samples. These observational results suggest that several taxa in the maternal blood microbiome are associated with PTB. Further studies are needed to confirm the composition of the blood microbiota in women with PTB. Additionally, the mechanism by which pathogenic microbes in maternal blood cause infection and PTB requires further analysis.

Highlights

  • 15 million babies are born prematurely each year (Lawn et al, 2013), defined as parturition before 37 weeks of gestation

  • Our study investigated the characteristics of the blood microbiota during healthy pregnancy and its association with preterm birth (PTB) by sequencing the V3–V4 region of the 16S rRNA gene

  • Bacterial diversity was similar in number and composition between the first, second, and third trimesters

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Summary

Introduction

15 million babies are born prematurely each year (Lawn et al, 2013), defined as parturition before 37 weeks of gestation. 40% of PTBs spontaneously occur because of infection and inflammation, including associations with subclinical intrauterine, intra-amniotic, and extrauterine maternal infections, such as periodontal disease (Goldenberg and Culhane, 2006; Mysorekar and Cao, 2014). Most intra-amniotic infections are thought to occur when the microbiome in the lower genital tract (vagina and/or cervix) gains access to the amniotic fluid (Romero et al, 2006). Microbial infection of the amniotic fluid, vaginal canal, and oral cavity is known to significantly contribute to PTB (Ryan and Ray, 2004; Menon, 2008; Yoo et al, 2016)

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