Abstract
Preterm birth poses a global challenge with a continuously increasing disease burden during the last decades. Advances in understanding the etiopathogenesis did not lead to a reduction of prematurely born infants so far. A balanced development of the host microbiome in early life is key for the maturation of the immune system and many other physiological functions. With the tremendous progress in new diagnostic possibilities, the contribution of microbiota changes to preterm birth and the acute and long-term sequelae of prematurity have come into the research focus. This review summarizes the latest advances in the understanding of microbiomes in the amniotic cavity and the female lower genital tract and how changes in microbiota structures contribute to preterm delivery. The exhibition of these highly vulnerable infants to the hostile environment in the neonatal intensive care unit necessarily entails the rapid colonization with a nonbalanced microbiome in a situation where the organism is still very prone and at an early stage of development. The global research efforts to decipher pathologic changes will pave the way to new pre- and postnatal therapeutic concepts.
Highlights
Microbiomes comprise commensal, symbiotic, and pathogenic bacteria, fungi, and viruses, which form an ecological entity and interact with themselves and with their particular host
In this review we present the latest insights into the structure and function of our microbiome and how pathologic changes contribute to preterm labor, premature birth, and the acute and long-term sequelae of prematurely born infants
Bronchopulmonary dysplasia (BPD) is the chronic lung disease of the preterm infant leading to life-long limitations oral cavity microbiome placental microbiome gut microbiome amniotic fluid microbiome cervical microbiome vaginal microbiome in lung function [59]
Summary
Microbiomes comprise commensal, symbiotic, and pathogenic bacteria, fungi, and viruses, which form an ecological entity and interact with themselves and with their particular host. The mode of delivery either by vaginal birth or by caesarian section determines microbial diversity and whether the gut is primarily colonized by the maternal vaginal and fecal or the skin microbiota These data are a first scientific indication that early events have a long-term health impact on microbiota structures [17,18,19,20]. The long-prevailing concept of bacterial ascension or transmission from the urogenital tract as the main driver of chorioamnionitis and amniotic inflammation was based on the bacteriological detection of microbes typically present They include bacterial species of the genera Streptococcus, E. coli, Gardnerella spp., Prevotella, Gonorrhea, Treponema, Chlamydia, Ureaplasma, and Mycoplasma as well as yeasts like Candida [13, 36,37,38]. This underlines the concept that a change in maternal gut microbiota is one of the responsible triggers [54]
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