The composition of the maternal vaginal microbiome influences the duration of pregnancy, onset of labor, and even neonatal outcomes. Maternal microbiome research in sub-Saharan Africa has focused on non-pregnant and postpartum composition of the vaginal microbiome. Here we aimed to illustrate the relationship between the vaginal microbiome of 99 laboring Ugandan women and intrapartum fever using routine microbiology and 16S ribosomal RNA gene sequencing from two hypervariable regions (V1–V2 and V3–V4). To describe the vaginal microbes associated with vaginal microbial communities, we pursued two approaches: hierarchical clustering methods and a novel Grades of Membership (GoM) modeling approach for vaginal microbiome characterization. Leveraging GoM models, we created a basis composed of a preassigned number of microbial topics whose linear combination optimally represents each patient yielding more comprehensive associations and characterization between maternal clinical features and the microbial communities. Using a random forest model, we showed that by including microbial topic models we improved upon clinical variables to predict maternal fever. Overall, we found a higher prevalence of Granulicatella, Streptococcus, Fusobacterium, Anaerococcus, Sneathia, Clostridium, Gemella, Mobiluncus, and Veillonella genera in febrile mothers, and higher prevalence of Lactobacillus genera (in particular L. crispatus and L. jensenii), Acinobacter, Aerococcus, and Prevotella species in afebrile mothers. By including clinical variables with microbial topics in this model, we observed young maternal age, fever reported earlier in the pregnancy, longer labor duration, and microbial communities with reduced Lactobacillus diversity were associated with intrapartum fever. These results better defined relationships between the presence or absence of intrapartum fever, demographics, peripartum course, and vaginal microbial topics, and expanded our understanding of the impact of the microbiome on maternal and potentially neonatal outcome risk.

母体阴道微生物组的组成会影响怀孕持续时间、分娩开始甚至新生儿结局。撒哈拉以南非洲的母体微生物组研究主要集中在阴道微生物组的非妊娠和产后组成。在这里，我们旨在使用常规微生物学和来自两个高变区（V1-V2 和 V3-V4）的 16S 核糖体 RNA 基因测序来说明 99 名乌干达妇女的阴道微生物组与产时发热之间的关系。为了描述与阴道微生物群落相关的阴道微生物，我们采用了两种方法：层次聚类方法和用于阴道微生物组表征的新型成员等级 (GoM) 建模方法。利用 GoM 模型，我们创建了一个由预先指定数量的微生物主题组成的基础，其线性组合最佳地代表了每个患者，从而在母体临床特征和微生物群落之间产生更全面的关联和表征。我们使用随机森林模型表明，通过包含微生物主题模型，我们改进了临床变量来预测母体发烧。总体而言，我们发现 of 粒状杆菌属、链球菌属、梭杆菌属、厌氧球菌属、Sneathia属、梭菌属、Gemella属、Mobiluncus属和Veillonella属在发热母亲中，乳杆菌属（尤其是卷曲乳杆菌和詹氏乳杆菌）、不动杆菌属、气球菌属和普雷沃氏菌属的流行率较高不发热母亲的物种。通过在该模型中包含微生物主题的临床变量，我们观察到年轻的产妇年龄、怀孕早期报告的发烧、更长的分娩时间以及乳酸杆菌多样性降低的微生物群落与产时发热相关。这些结果更好地定义了产时发热的存在与否、人口统计学、围产期病程和阴道微生物主题之间的关系，并扩大了我们对微生物组对母体和潜在新生儿结局风险影响的理解。