The Vaginal Microbiome and Pregnancy Outcomes
There are predictable and necessary immunologic, metabolic, and hormonal changes that allow a pregnant individual to provide nutrients and space for the developing fetus without mounting an immune response against it8. During a normal, healthy pregnancy, the microbiome becomes less diverse overall20. There is limited understanding of what changes constitute normal, healthy changes or changes which lead to pregnancy complications. It is known that pregnant individuals are more susceptible to UTIs, BV flare ups, and Candida infections during pregnancy21, and the changes in vaginal microbiome during pregnancy could play a role in this increased susceptibility. A vaginal microbiome that lacksLactobacillus is associated with increased risk for preterm birth2,22,23, a leading cause of infant mortality in the United States24. However, it is not clear that the microbiome is a stronger predictor than other known risk factors, such as racism and stress22. For a more thorough review of the vaginal microbiome in pregnancy outcomes, please see Edwards et al.8.