Race, the Vaginal Microbiome, and Spontaneous Preterm Birth
Shan Sun, Myrna G. Serrano, Jennifer M. Fettweis, Patricia V. Basta, Emma M. Rosen, Kim Ludwig, Alicia A. Sorgen, Ivory Blakley, Michael C. Wu, Nancy Dole, John M. Thorp, Anna Maria Siega‐Riz, Gregory A. Buck, Anthony A. Fodor, Stephanie M. Engel
Abstract
Approximately 10% of all pregnancies in the United States end in preterm birth, and over 14% of pregnancies end in preterm birth among Black women. Knowledge on the associations between vaginal microbiome and preterm birth is important for understanding the potential cause and assessing risk of preterm birth. Our study is one of the largest studies performed to date to investigate the associations between vaginal microbiome and spontaneous preterm birth (sPTB), with stratified design for Black and White women. We found that the vaginal microbiome was different between Black and White women. The vaginal microbiome was associated with sPTB, and a lower abundance of L. crispatus increased the risk of sPTB independent of racial differences in microbial community structures. Furthermore, we also found that vaginal douching obscured the associations between vaginal microbiome, race, and preterm birth, suggesting that vaginal douching is an important factor to consider in future studies.