Preterm birth (PTB) is the largest contributor to infant death in sub-Saharan Africa and globally. With a global estimate of 773,600, Nigeria has the third highest rate of PTB worldwide. There have been a number of microbiome profiling studies to identify vaginal microbiomes suggestive of preterm and healthy birth outcome. However, studies on the pregnancy vaginal microbiome in Africa are sparse with none performed in Nigeria. Moreover, few studies have considered the concurrent impact of steroid hormones and the vaginal microbiome on pregnancy outcome. We assessed two key determinants of pregnancy progression to gain a deeper understanding of the interactions between vaginal microbiome composition, steroid hormone concentrations, and pregnancy outcome. Vaginal swabs and blood samples were prospectively collected from healthy midtrimester pregnant women. Vaginal microbiome compositions were assessed by analysis of the V3-V5 region of 16S rRNA genes, and potential functional metabolic traits of identified vaginal microbiomes were imputed by PICRUSt (phylogenetic investigation of communities by reconstruction of unobserved states) analysis, while plasma estradiol (E2) and progesterone (P1) levels were quantified by the competitive enzyme-linked immunosorbent assay (ELISA). PTB vaginal samples were characterized by increased microbial richness, high diversity, and depletion of lactobacilli compared to term delivery samples. Women who delivered preterm were characterized by an Atopobium vaginae-dominated vagitype. High relative abundance of Atopobium vaginae at the midtrimester was highly predictive of PTB (area under the receiving operator characteristics [AUROC] of 0.983). There was a marked overlap in the range of plasma E2 and P1 values between term and PTB groups.

中文翻译：

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Atopobium v​​aginae 在中期的优势：尼日利亚队列中早产风险的潜在指标

早产 (PTB) 是撒哈拉以南非洲和全球婴儿死亡的最大原因。全球估计有 773,600 人，尼日利亚的 PTB 率在全球排名第三。已经有许多微生物组分析研究来确定暗示早产和健康出生结果的阴道微生物组。然而，关于非洲怀孕阴道微生物组的研究很少，尼日利亚没有进行过任何研究。此外，很少有研究考虑类固醇激素和阴道微生物群对妊娠结局的并发影响。我们评估了妊娠进展的两个关键决定因素，以更深入地了解阴道微生物组组成、类固醇激素浓度和妊娠结局之间的相互作用。阴道拭子和血液样本是从健康的孕中期孕妇身上收集的。通过分析 16S rRNA 基因的 V3-V5 区域来评估阴道微生物组组成，并通过 PICRUSt（通过重建未观察到的状态对群落进行系统发育调查）分析来估算已鉴定阴道微生物组的潜在功能代谢特征，而血浆雌二醇 (E2)和孕酮 (P1) 水平通过竞争性酶联免疫吸附测定 (ELISA) 进行量化。与足月分娩样品相比，PTB 阴道样品的特点是微生物丰富度增加、多样性高和乳酸杆菌减少。早产妇女的特点是 PICRUSt（通过重建未观察到的状态对群落进行系统发育调查）分析推算已鉴定阴道微生物群的潜在功能代谢特征，而血浆雌二醇 (E2) 和孕酮 (P1) 水平则通过竞争性酶联免疫吸附试验 (ELISA) 进行量化）。与足月分娩样品相比，PTB 阴道样品的特点是微生物丰富度增加、多样性高和乳酸杆菌减少。早产妇女的特点是 PICRUSt（通过重建未观察到的状态对群落进行系统发育调查）分析推算已鉴定阴道微生物群的潜在功能代谢特征，而血浆雌二醇 (E2) 和孕酮 (P1) 水平则通过竞争性酶联免疫吸附试验 (ELISA) 进行量化）。与足月分娩样品相比，PTB 阴道样品的特点是微生物丰富度增加、多样性高和乳酸杆菌减少。早产妇女的特点是 与足月分娩样品相比，PTB 阴道样品的特点是微生物丰富度增加、多样性高和乳酸杆菌减少。早产妇女的特点是 与足月分娩样品相比，PTB 阴道样品的特点是微生物丰富度增加、多样性高和乳酸杆菌减少。早产妇女的特点是Atopobium v​​aginae主导的阴道型。妊娠中期阴道 Atopobium 的高相对丰度对PTB 具有高度预测性（接收操作员特征下的面积 [AUROC] 为 0.983）。足月组和 PTB 组之间的血浆 E2 和 P1 值范围有明显的重叠。