Does vaginal bacterial colonization contribute to preterm birth in women with asymptomatic shortened cervix?

Arch Gynecol Obstet. 2024 Apr 5. doi: 10.1007/s00404-024-07397-2. Online ahead of print.

Abstract

Purpose: The aim of this study is to describe the typical microbial spectrum and the influence of distinct vaginal infections on preterm birth in pregnancies affected by cervical incompetence.

Methods: 327 patients were admitted because of asymptomatic shortening of the cervix in the second and third trimester of pregnancy. Clinical data such as age, cervical length, gestational age at admission and at delivery and vaginal microbiologic findings were collected and analyzed.

Results: The spectrum of germs in the vagina revealed seven different distinct species; the most common bacteria were Ureaplasma spp. and E. coli. In 327 included patients, 217 revealed a bacterial colonization, 110 did not. Most common bacteria in women with preterm birth before 34 weeks were Ureaplasma spp., while E. coli was most common in women undergoing preterm birth after 34 weeks. Nevertheless, the rates of occurrence of these bacterial taxa were not significantly different between who underwent preterm birth to those who did not.

Conclusions: This study gives an overview over the vaginal bacterial colonization in pregnant women with cervical incompetence. The clinical relevance of vaginal bacterial colonization remains unclear.

Keywords: Ureaplasma; Asymptomatic shortened cervix; Pregnancy; Preterm delivery; Vaginal bacterial colonization.