Does the Vaginal Microbiota Influence the Incidence of the Preterm Premature Rupture of Membranes?

Abstract

Introduction: The study aimed to provide a systematic review and analysis of previously reported studies investigating the association between the bacterial microbiome and the incidence of preterm premature rupture of membranes (PPROM). Material and Methods: A comprehensive literature search across many databases via 01 March 2023, including PubMed, Web of Science, Embase, and the Cochrane Library. Results: A total of 20 studies were reviewed, all of which provided a comprehensive analysis of the microbial makeup in pregnant women. The findings suggest that disturbances in the bacterial microflora correlate with a heightened risk of PPROM. Conclusions: There was a significant reduction of naturally prevalent vaginal species (in the vaginal flora of women with PPROM such as Lactobacillus spp., Weissella spp., and Rickettsiales spp. This was accompanied by the dominance of other bacterial species such as Sneathia spp., Prevotella spp., Prevotella bivia, Prevotella timonensis, Peptniphilus, Streptococcus spp., Dialister spp., Lactobacillus iners, Gardnerella vaginalis, Ochrobactrum spp. Megasphaera spp., Faecalibacterium spp., Bifidobacterium spp., Xanthomonadales spp., Gammaproteobacteria spp., Alphaproteobacteria spp., Bacteroides spp., Sphingomonas spp., Streptococcus agalactiae, Escherichia coli, Staphylococcus aureus, Chlamydia trachomatis, Ureaplasma urealyticum, Ureaplasma parvum or Group B Streptococcus begin to dominate, leading to PPROM. Recognising the microbial patterns could lead to the development of risk-based microbiological interventions and probiotic treatment, potentially improving the management and outcomes of patients with PPROM.

Keywords: PPROM; microbiome; preterm premature rupture of membranes; vaginal flora.

Figure 1

Flow diagram of the study selection.