The role of vaginal microbiota dysbiosis in the etiology of preterm labor: A microbiological investigation

Background: The occurrence of preterm labor stands as one of the main contributors to infant health issues, which results in deaths worldwide. Studies presently demonstrate that preterm labor often begins because of changes in the vaginal microbiota where Lactobacillus levels decrease and multiple anaerobic bacteria grow excessively. The research evaluated vaginal microbiota dysbiosis as an etiological factor for preterm labor through prospective microbial profile analysis of pregnant women. Material and Methods: This prospective observational study was conducted at Indus Medical College and Hospital, Tando Muhammad Khan, from January 2021 to December 2022. Vaginal samples were collected at 20–24 weeks of gestation for 16S rRNA gene analysis using next-generation sequencing. Clinical data included gestational age at delivery, cervical length, and inflammatory markers. Sample size was calculated based on an estimated effect size of 0.3, 80% power, and α = 0.05. Results: The study revealed preterm labor patients (n = 70) had decreased levels of Lactobacillus species together with elevated counts of anaerobic organisms (Gardnerella and Atopobium) compared to birth patients (n = 280) at p<0.001. Conclusion: The measurements of inflammatory cytokines demonstrated a connection to the severity of dysbiosis detected in females. Statistical tests using multiple variables showed particular sets of microorganisms function separately as predictors for premature birth. Finally, the study demonstrates that dietary interventions for altering vaginal microbial balance pose major significance for pregnancy maintenance while offering new diagnostic and therapeutic possibilities. Keywords: Microbiota, Preterm labour, Labour dysbosis. Dysbosis etiology