Women at risk of giving birth prematurely could be identified by looking at bacteria living in their reproductive tract, new research suggests.
Falling levels of the strain Lactobacillus, alongside increases in other bacteria, are associated with a woman’s waters breaking after less than 37 weeks of pregnancy, a study found today.
Previous research reveals bacteria levels fluctuate during pregnancy to protect the baby from harmful pathogens.
Such bacterial changes also increase the risk of poor health in the mother and infant, with some babies being more likely to develop life-threatening sepsis, the research adds.
Lead scientist Dr David MacIntyre, from Imperial College London, said: ‘This study is one of the first to show that almost half of pregnant women may have an unbalanced vaginal microbiota before premature rupture, providing further evidence of the role of bacteria in some cases of premature births.
‘Crucially, our findings identify two different groups of women with premature rupture – one group in which targeted antibiotics may be beneficial and the other in which this same treatment may actually be detrimental.’
Around 60,000 babies are born prematurely each year in the UK.
How the research was carried out
The researchers analysed 250 pregnant women with and without risk factors for giving birth prematurely.
Such risks include previously giving birth early, having twins or more and waiting less than six months between pregnancies.
Of the women assessed, 27 delivered their babies prematurely.
Some 87 different women seen at hospital after their waters broke prematurely were also studied.
‘One size fits all’ approach is ineffective
The results further reveal standard antibiotic treatment helped reduce infection in most of the study’s participants whose waters broke early, yet for others such therapy proved harmful.
This could be due to the drugs wiping out ‘good bacteria’ and allowing dangerous pathogens to take their place, the researchers believe.
Dr MacIntyre said: ‘This study is one of the first to show that almost a half of pregnant women may have an unbalanced vaginal microbiota before premature rupture, providing further evidence of the role of bacteria in some cases of premature births.
‘Crucially, our findings identify two different groups of women with premature rupture – one group in which targeted antibiotics may be beneficial and the other in which this same treatment may actually be detrimental.’
Study author Dr Richard Brown added: ‘Our results suggest that a more personalised approach targeting only those women likely to benefit from antibiotics may prove more beneficial than the current “one treatment fits all” approach.’
The findings were published in the journal BMC Medicine.
