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The role of the microbiome in pregnancy


Authors: Hornová M.;  Pařízek A.;  Koucký M.
Authors‘ workplace: Gynekologicko-porodnická klinika 1. LF UK a VFN v Praze
Published in: Ceska Gynekol 2021; 86(6): 422-427
Category: Review Article
doi: https://doi.org/10.48095/cccg2021422

Overview

Objective: To provide a comprehensive overview of the available information on the maternal microbio­me and its effect on pregnancy and preterm birth. Methods: Systematic review of available literature on the topic was done using the PubMed database. Conclusion: Etiology of preterm labor is multifactorial. Individual setting of humoral and cellular immune response is key; however, lately the focus has shifted to the role of the microbio­me, especially the vaginal one. The role of additional microbio­mes and the relationship between different compartments are the focus of intensive research. Mainly the differences in the maternal and neonatal microbio­me depend on the method of delivery and administration of different antibio­tics during pregnancy and labor. The uterine cavity is no longer thought to be without colonization and the formation of the fetal microbio­me begins early in pregnancy.

Keywords:

Preterm labor – microbio­me – antibio­tics – microbial invasion of amniotic cavity – vaginal seeding


Sources

1. Gensollen T, Iyer SS, Kasper DL et al. How colonization by microbio­ta in early life shapes the immune system. Science 2016; 352 (6285): 539–544. doi: 10.1126/science.aad9378.

2. Kacerovský M, Kokrdová Z, Koucký M et al. Spontánní předčasný porod, doporučený postup České gynekologické a porodnické společnosti (ČGPS) a České lékařské společnosti Jana Evangelisty Purkyně (ČLS JEP). 2021 [online]. Dostupné z: http: //www.gynultrazvuk.cz/doporucene-postupy.

3. Koucký M, Malíčková K, Hrdý J et al. The role of maternal imunity and woman’s microbio­me in the pathogenesis of preterm labor. Ceska Gynekol 2017; 82 (5): 407–410.

4. Gomez-Lopez N, StLouis D, Lehr MA et al. Immune cells in term and preterm labor. Cell Mol Immunol 2014; 11 (6): 571–581. doi: 10.1038/cmi.2014.46.

5. Tong M, Abrahams VM. Immunology of the placenta. Obstet Gynecol Clin North Am 2020; 47 (1): 49–63. doi: 10.1016/j.ogc.2019.10.006.

6. Regal JF, Gilbert JS, Burwick RM. The complement system and adverse pregnancy outcomes. Mol Immunol 2015; 67 (1): 56–70. doi: 10.1016/j.molimm.2015.02.030.

7. Green ES, Arck PC. Pathogenesis of preterm birth: bidirectional inflammation in mother and fetus. Semin Immunopathol 2020; 42 (4): 413–429. doi: 10.1007/s00281-020-00807-y.

8. Prince AL, Chu DM, Seferovic MD et al. The perinatal microbio­me and pregnancy: moving beyond the vaginal microbio­me. Cold Spring Harb Perspect Med 2015; 5 (6): a023051. doi: 10.1101/cshperspect.a023051.

9. Devaraj S, Hemarajata P, Versalovic J. The human gut microbio­me and body metabolism: implications for obesity and diabetes. Clin Chem 2013; 59 (4): 617–628. doi: 10.1373/clinchem.2012.187617.

10. Wang T, Cai G, Qiu Y et al. Structural segregation of gut microbio­ta between colorectal cancer patients and healthy volunteers. ISME J 2012; 6 (2): 320–329. doi: 10.1038/ismej.2011.109.

11. Qin J, Li Y, Cai Z et al. A metagenome-wide association study of gut microbio­ta in type 2 diabetes. Nature 2012; 490 (7418): 55–60. doi: 10.1038/nature11450.

12. Prince AL, Ma J, Kannan PS et al. The placental membrane microbio­me is altered among subjects with spontaneous preterm birth with and without chorioamnionitis. Am J Obstet Gynecol 2016; 214 (5): 627.e1–627.e16. doi: 10.1016/j.ajog.2016.01.193.

13. Tétu A, Guerby P, Rallu F et al. Mid-trimester microbial invasion of the amniotic cavity and the risk of preterm birth. J Matern Fetal Neonatal Med 2020: 1–4. doi: 10.1080/14767058.2020.1846704.

14. Rowlands S, Danielewski JA, Tabrizi SN et al. Microbial invasion of the amniotic cavity in mid­- trimester pregnancies using molecular micro­bio­logy. Am J Obstet Gynecol 2017; 217 (1): 71.e1–71.e5. doi: 10.1016/j.ajog.2017.02.051.

15. Crha I, Ventruba P, Žáková J et al. Děložní mikrobio­m jako faktor receptivity endometria. Ceska Gynekol 2019; 84 (1): 49–54.

16. Eisenhofer R, Minich JJ, Marotz C et al. Contamination in low microbial bio­mass microbio­me studies: issues and recommendations. Trends Microbio­l 2019; 27 (2): 105–117. doi: 10.1016/j.tim.2018.11.003.

17. Bardos J, Fiorentino D, Longman RE et al. Immunological role of the maternal uterine microbio­me in pregnancy: pregnancies pathologies and alterated microbio­ta. Front Immunol 2020; 10: 2823. doi: 10.3389/fimmu.2019.02823.

18. Baker JM, Chase DM, Herbst-Kralovetz MM. Uterine microbio­ta: residents, tourists, or invaders? Front Immunol 2018; 9: 208. doi: 10.3389/ fimmu.2018.00208.

19. Theis KR, Romero R, Winters AD et al. Does the human placenta delivered at term have a microbio­ta? Results of cultivation, quantitative real-time PCR, 16S rRNA gene sequencing, and metagenomics. Am J Obstet Gynecol 2019; 220 (3): 267.e1–267.e39. doi: 10.1016/j.ajog.2018.10.018.

20. Zhu L, Luo F, Hu W et al. Bacterial communities in the womb during healthy pregnancy. Front Microbio­l 2018; 9: 2163. doi: 10.3389/fmicb.2018.02163.

21. Leiby JS, McCormick K, Sherrill-Mix S et al. Lack of detection of a human placenta microbio­me in samples from preterm and term deliveries. Microbio­me 2018; 6 (1): 196. doi: 10.1186/s40168-018-0575-4.

22. Ravel J, Gajer P, Abdo Z et al. Vaginal microbio­me of reproductive-age women. Proc Natl Acad Sci U S A 2011; 108 (Suppl 1): 4680–4687. doi: 10.1073/pnas.1002611107.

23. Witkin SS. The vaginal microbio­me, vaginal anti-microbial defence mechanisms and the clinical challenge of reducing infection-related preterm birth. BJOG 2015; 122 (2): 213–218. doi: 10.1111/1471-0528.13115.

24. Vinturache AE, Gyamfi-Bannerman C, Hwang J et al. Preterm Birth International Collaborative (PREBIC). Maternal microbio­me – a pathway to preterm birth. Semin Fetal Neonatal Med 2016; 21 (2): 94–99. doi: 10.1016/j.siny.2016.02.004.

25. Mendling W. Vaginal microbio­ta. Adv Exp Med Biol 2016; 902: 83–93. doi: 10.1007/ 978-3-319-31248-4_6.

26. Brown RG, Al-Memar M, Marchesi JR et al. Establishment of vaginal microbio­ta composition in early pregnancy and its association with subsequent preterm prelabor rupture of the fetal membranes. Transl Res 2019; 207: 30–43. doi: 10.1016/j.trsl.2018.12.005.

27. Tabatabaei N, Eren AM, Barreiro LB et al. Vaginal microbio­me in early pregnancy and subsequent risk of spontaneous preterm birth: a case-control study. BJOG 2019; 126 (3): 349–358. doi: 10.1111/1471-0528.15299.

28. Hyman RW, Fukushima M, Jiang H et al. Diversity of the vaginal microbio­me correlates with preterm birth. Reprod Sci 2014; 21 (1): 32–40. doi: 10.1177/1933719113488838.

29. Stout MJ, Zhou Y, Wylie KM et al. Early pregnancy vaginal microbio­me trends and preterm birth. Am J Obstet Gynecol 2017; 217 (3): 356.e1–356.e18. doi: 10.1016/j.ajog.2017.05.030.

30. Mls J, Stráník J, Kacerovský M. Lactobacillus iners-dominantní vaginální mikrobio­ta v těhotenství. Ceska Gynekol 2019; 84 (6): 463–467.

31. Kindinger LM, Bennett PR, Lee YS et al. The interaction between vaginal microbio­ta, cervical length, and vaginal progesterone treatment for preterm birth risk. Microbio­me 2017; 5 (1): 6. doi: 10.1186/s40168-016-0223-9.

32. Elovitz MA, Gajer P, Riis V et al. Cervicovaginal microbio­ta and local immune response modulate the risk of spontaneous preterm delivery. Nat Commun 2019; 10 (1): 1305. doi: 10.1038/s41467-019-09285-9.

33. Mor G, Kwon JY. Trophoblast – microbio­me interaction: a new paradigm on immune regulation. Am J Obstet Gynecol 2015; 213 (Suppl 4): S131–S137. doi: 10.1016/j.ajog.2015.06.039.

34. Záhumenský J, Hederlingová J, Pšenková P. Význam materského mikrobiómu v tehotnosti. Ceska gynekol 2017; 82 (3): 211–217.

35. Power ML, Quaglieri C, Schulkin J. Reproductive microbio­mes: a new thread in the microbial network. Reprod Sci 2017; 24 (11): 1482–1492. doi: 10.1177/1933719117698577.

36. Chu DM, Seferovic M, Pace RM et al. The microbio­me in preterm birth. Best Pract Res Clin Obstet Gynaecol 2018; 52: 103–113. doi: 10.1016/j.bpobgyn.2018.03.006.

37. Cobb CM, Kelly PJ, Williams KB et al. The oral microbio­me and adverse pregnancy outcomes. Int J Womens Health 2017; 9: 551–559. doi: 10.2147/IJWH.S142730.

38. Connor KL, Chehoud C, Chan L et al. Reproductive Sciences. Maternal diet shapes the gut microbio­me, impacting immune status in pregnancy. Vol. 21. USA, CA: Thousand Oaks  2014.

39. Atarashi K, Tanoue T, Shima T et al. Induction of colonic regulatory T cells by indigenous Clostridium species. Science 2011; 331 (6015): 337–341. doi: 10.1126/science.1198469.

40. Atarashi K, Tanoue T, Oshima K et al. Treg induction by a rationally selected mixture of Clostridia strains from the human microbio­ta. Nature 2013; 500 (7461): 232–236. doi: 10.1038/nature12331.

41. Lee N, Kim WU. Microbio­ta in T-cell homeostasis and inflammatory diseases. Exp Mol Med 2017; 49 (5): e340. doi: 10.1038/emm.2017.36.

42. Reyman M, van Houten MA, van Baarle D et al. Impact of delivery mode-associated gut microbio­ta dynamics on health in the first year of life. Nat Commun 2019; 10 (1): 4997. doi: 10.1038/s41467-019-13014-7.

43. Dierikx TH, Visser DH, Benninga MA et al. The influence of prenatal and intrapartum antibio­tics on intestinal microbio­ta colonisation in infants: a systematic review. J Infect 2020; 81 (2): 190–204. doi: 10.1016/j.jinf.2020.05.002.

44. Zimmermann P, Curtis N. Effect of intrapartum antibio­tics on the intestinal microbio­ta of infants: a systematic review. Arch Dis Child Fetal Neonatal Ed 2020; 105 (2): 201–208. doi: 10.1136/archdischild-2018-316659.

45. Marrs T, Jo JH, Perkin MR et al. Gut microbio­ta development during infancy: impact of introducing allergenic foods. J Allergy Clin Immunol 2021; 147 (2): 613.e9–621.e9. doi: 10.1016/j.jaci.2020.09.042.

46. Galazzo G, van Best N, Bervoets L et al. Development of the microbio­ta and associations with birth mode, diet, and atopic disorders in a longitudinal analysis of stool samples, collected from infancy through early childhood. Gastroenterology 2020; 158 (6): 1584–1596. doi: 10.1053/j.gastro.2020.01.024.

47. Zheng H, Liang H, Wang Y et al. Altered gut microbio­ta composition associated with Eczema in infants. PLoS One 2016; 11 (11): e0166026. doi: 10.1371/journal.pone.0166026.

48. Sordillo JE, Zhou Y, McGeachie MJ et al. Factors influencing the infant gut microbio­me at age 3–6 months: findings from the ethnically diverse Vitamin D Antenatal Asthma Reduction Trial (VDAART). J Allergy Clin Immunol 2017; 139 (2): 482.e14–491.e14. doi: 10.1016/j.jaci.2016.08.045.

49. Gholizadeh P, Mahallei M, Pormohammad A et al. Microbial balance in the intestinal microbio­ta and its association with diabetes, obesity and allergic disease. Microb Pathog 2019; 127: 48–55. doi: 10.1016/j.micpath.2018.11.031.

50. Soderborg TK, Clark SE, Mulligan CE et al. The gut microbio­ta in infants of obese mothers increases inflammation and susceptibility to NAFLD. Nat Commun 2018; 9 (1): 4462. doi: 10.1038/s41467-018-06929-0.

51. Štefan M, Vojtěch J. Antibio­tická terapie v graviditě. Ceska Gynekol 2018; 83 (1): 70–80.

52. Chu DM, Ma J, Prince AL et al. Maturation of the infant microbio­me community structure and function across multiple body sites and in relation to mode of delivery. Nat Med 2017; 23 (3): 314–326. doi: 10.1038/nm.4272.

53. Aagaard KM. Mode of delivery and pondering potential sources of the neonatal microbio­me. EBioMedicine 2020; 51: 102554. doi: 10.1016/j.ebio­m.2019.11.015.

54. Limaye MA, Ratner AJ. ‚Vaginal seeding‘ after a caesarean section provides benefits to newborn children: AGAINST: Vaginal microbio­me transfer – a medical procedure with clear risks and uncertain benefits. BJOG 2020; 127 (2): 302. doi: 10.1111/1471-0528.15977.

55. Cunnington AJ, Sim K, Deierl A et al. „Vaginal seeding“ of infants born by caesarean section. BMJ 2016; 352: i227. doi: 10.1136/bmj. i227.

56. Eschenbach DA. Vaginal seeding: more questions than answers. BJOG 2018; 125 (5): 537. doi: 10.1111/1471-0528.14815.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
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