Overview
Preterm birth (<37 weeks gestation) is the leading cause of neonatal mortality and morbidity worldwide (~15 million/year). The vaginal microbiome is a key determinant of preterm birth risk — Lactobacillus-depleted vaginal communities (CST-IV, enriched in gardnerella, atopobium, sneathia, megasphaera, prevotella) are associated with increased risk of ascending infection, cervical inflammation, and preterm delivery pruski 2021 desi ms vaginal microbiome preterm birth.
Microbiome Connection
- Protective: lactobacillus crispatus (CST-I) dominance — lowest preterm risk via D-lactic acid production and barrier maintenance.
- Risk: CST-IV (BV-associated) communities → ascending infection → chorioamnionitis → preterm labor.
- Ureaplasma: Colonization in preterm infants associated with bronchopulmonary dysplasia pendergrass 2026 nickel nec preterm gut.
Metal Connection
- Prenatal trace element exposure affects infant gut microbiome programming and preterm birth risk xiong 2025 prenatal trace elements infant gut microbiome.
- Nickel in preterm formula may fuel pathogen expansion contributing to necrotizing enterocolitis post-delivery pendergrass 2026 nickel nec preterm gut.
- Statins explored for preterm delivery prevention whitaker 2021 statins preterm delivery prevention.
Cross-References
- bacterial vaginosis — BV as primary preterm risk factor
- lactobacillus crispatus — protective CST-I dominance
- necrotizing enterocolitis — consequence in preterm survivors
- ureaplasma — preterm colonization and BPD
- gestational diabetes — GDM increases preterm risk