The Cervical Microbiome and Parturition

Purpose: The importance of the microbes that reside in and on the human body are increasingly recognized for the action they carry out, influencing human health, behavior, and disease through immunologic, endocrine, and neural pathways. The National Institutes of Health completed the Human Microbiome Project and is now engaged in the integrative Human Microbiome Project 2 which aims to examine changes in the microbiome and human health. While many body sites have been examined, there has been little study of the cervix and myometrium, two key reproductive tissues that hold promise for better understanding of significant perinatal problems such as preterm birth. The purpose of this exploratory research is three-fold:  1) describe the indigenous microbiota in late pregnancy and parturition, 2) provide preliminary data regarding the corresponding indigenous myometrial microbiota, 3) characterize the cervical microbiotic pattern contributing to normal physiologic birth outcomes.

Methods: This research enrolls 20 healthy pregnant white women, 18-35 years of age, with normal body mass index (BMI), and who present for prenatal care at a birth center in the Southwest United States. Women enrolled in this prospective study have cervical specimens collected at 2 points:  at 35-37 weeks and at the onset of labor. Where the participant has a Cesarean birth, a myometrial specimen is obtained to provide preliminary data regarding microbiota community taxonomic composition and diversity and how that compares with that found in the cervix. A standardized collection and processing model is being used to swab the cervix with preservation of samples by immediate freezing. Demographics, baseline clinical characteristics, and select perinatal outcomes are examined in relation to the community of microbes noted in the cervix. Dietary intake (24 hour recall) - a select host factor is also examined for consideration of potential impact on noted microbiota and associated perinatal outcomes. 

Results: Data will be analyzed to characterize the cervical and uterine microbial communities and determination of correlations between differences in the microbiome and perinatal outcomes with microbiome compositions being measured by 16S rRNA gene sequencing.

Conclusion: The goal of this research is to promote health in pregnancy and improve perinatal outcomes.  Findings have the potential for further refinement of personalized medicine for pregnant women, including development of biomarkers which could be key in the development of targeted interventions capable of promoting or blocking parturition at less desirable endpoints.