Pregnancy and the Vaginal Microbiome: Unravelling the Impact of Prenatal Changes

The vaginal microbiome undergoes profound changes during pregnancy, marked by shifts in microbial composition and diversity that significantly impact maternal health. While the importance of these shifts is increasingly recognised, the tools to interpret these changes remain limited.

What We Know:

• The vaginal microbiome plays a pivotal role in pregnancy, with a healthy state predominantly featuring Lactobacillus species. These bacteria help maintain a low pH, protecting against infections. Microbial dysbiosis is linked to complications such as preterm birth (PTB), miscarriage, gestational diabetes mellitus (GDM), preeclampsia and chorioamnionitis (CAT) (Gerede et al., 2024).

• PTB is associated with increased levels of anaerobic bacteria like Gardnerella vaginalis and Prevotella. Communities dominated by L. iners or anaerobic bacteria carry higher risks compared to L. crispatus-dominant profiles. Similarly, miscarriage often correlates with reduced Lactobacillus abundance and greater microbial diversity. Dysbiosis not only disrupts the protective functions of the microbiome but also promotes inflammation and tissue damage, which can contribute to complications such as cervical insufficiency or placental ischemia (Gerede et al., 2024).

• In GDM, altered microbiota may exacerbate inflammatory pathways, worsening glucose intolerance. Elevated levels of Prevotella bivia have been implicated in inflammation associated with preeclampsia, while a diverse microbiome depleted of L. crispatus is linked to increased infection risks in CAT. These microbial shifts reflect dynamic interactions with maternal physiology and evolve across pregnancy trimesters (Parraga-Leo et al., 2024).

Industry Impact and Potential:

• Probiotic interventions to restore Lactobacillus dominance show promise for managing bacterial vaginosis, but their efficacy in preventing broader pregnancy complications warrants further investigation. New evidence suggests that microbial profiles and community disruptions could serve as biomarkers for identifying high-risk pregnancies (Parraga-Leo et al., 2024).

• Recent innovations include the Vaginal Microbiome Atlas during Pregnancy (VMAP), which integrates data from 11 studies and 3880 samples across 1402 individuals. This comprehensive resource leverages MaLiAmPi, a cutting-edge phylogenetic tool implemented via a Nextflow pipeline, to harmonise diverse datasets. By addressing technical variations and improving accuracy, MaLiAmPi enhances the reliability of microbiome data, setting a new standard for microbiome analysis (Parraga-Leo et al., 2024).

Our Solution:

Sequential specialises in microbiome analysis, offering services for assessing the vulvar microbiome alongside skin, scalp and oral microbiomes. Our expertise in developing products that maintain microbiome integrity positions us as industry leaders in supporting innovations for women’s health. 

References:

Gerede, A., Nikolettos, K., Vavoulidis, E., Margioula-Siarkou, C., Petousis, S., Giourga, M., Fotinopoulos, P., Salagianni, M., Stavros, S., Dinas, K., Nikolettos, N. & Domali, E. (2024) Vaginal Microbiome and Pregnancy Complications: A Review. Journal of Clinical Medicine. 13 (13), 3875. doi:10.3390/jcm13133875.

Parraga-Leo, A., Oskotsky, T.T., Oskotsky, B., Wibrand, C., Roldan, A., et al. (2024) VMAP: Vaginal Microbiome Atlas during Pregnancy. JAMIA open. 7 (3), ooae099. doi:10.1093/jamiaopen/ooae099.