Introduction
When a baby gets born before completing 37 weeks of intra-uterine life (gestational period), it is called preterm birth. Millions of preterm deliveries are reported every year. Preterm birth is a severe cause of death for babies under five. Preterm birth is a multifactorial problem. But it mainly occurs in cases where there are infections within the uterus. In conclusion, the microbiome in the cervix and vagina is crucial in causing infections and preterm deliveries.
Children born prematurely have an increased chance of health and developmental issues. They may even suffer from mental retardation. Bacterial vaginosis and a deficiency of essential nutrients and minerals lead to preterm delivery. Vaginal microbial balance can be restored with the help of probiotics. In addition, providing adequate nutrition helps prolong the gestation period and reduces the chances of preterm birth.
What Is Preterm Birth?
When a baby is born before completing 37 gestational weeks, the birth is called a preterm birth.
Preterm birth can be of two types:
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Indicated Preterm Birth: In some instances, for the well-being of the mother or the baby, the doctors may indicate and induce preterm birth, called indicated preterm birth.
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Spontaneous Preterm Birth: Spontaneous membrane rupture or immediate preterm labor leads to spontaneous preterm birth.
Why Is Preterm Birth Considered Serious?
The risks of developmental defects, health conditions, and mortality are higher in premature children. They may gradually develop respiratory, central nervous system, and gastrointestinal conditions. Their immunity will be weaker, making them susceptible to infections. Some babies may also have impaired visual and hearing abilities. Long-term cognitive, motor, social, and behavioral problems may make it challenging to lead an everyday life.
In addition to the risks to the baby, preterm birth may introduce financial strain and emotional distress to the families. Healthcare coverage, education, and other forms of social support may also be negatively impacted.
How Does the Cervicovaginal Microbiome Influence Preterm Birth Risk?
The beneficial Lactobacillus species dominate the normal cervicovaginal microbiome. During pregnancy, the balance in this microbiome is affected. An imbalanced microbiota, with the presence and action of excessive anaerobic bacteria, can lead to issues. Lactobacilli produce lactate and hydrogen peroxide, which help eliminate unwanted microbial organisms, reducing vaginal pH. These mechanisms reduce the risk of infections like bacterial vaginosis, the leading cause of spontaneous preterm birth.
The following points summarize the mechanisms that protect the cervicovaginal microbiome and help prevent or reduce the chances of preterm birth:
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As the dominant microorganism within a healthy vaginal tract, Lactobacillus species play a crucial role in maintaining vaginal balance. It prevents the establishment and proliferation of harmful microorganisms.
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Lactobacillus carries out its protective function through different mechanisms. It generates an acidic environment by decreasing the vaginal pH through lactate production, generating bioactive compounds, competing for nutrients, and influencing host immunity modulation.
What Are Probiotics?
Probiotics are live microorganisms that inhabit the human body, including beneficial bacteria and yeasts. Probiotics are made of advantageous and suitable microorganisms that do not cause any harm to the body. Probiotics play a crucial role in maintaining overall health and well-being. They counteract the excessive growth of harmful bacteria and improve health. Unlike other microorganisms, a probiotic microbe should exhibit specific characteristics.
It includes the following:
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It can be isolated from the human source.
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It can survive the digestive process following ingestion of the food.
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It should be advantageous to the human body and health.
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It should pose no harm when consumed.
Can Probiotics Effectively Reduce the Risk of Preterm Birth?
Studies are ongoing to prove the link between probiotics and the reduced risk of preterm birth. When the microbial balance within the mother's intestine is imbalanced, it leads to maternal dysbiosis. Maternal dysbiosis is characterized by an uneven distribution of bacterial composition, altered metabolic functions of the bacteria, or shifts in bacterial presence across the gastrointestinal system. Dysbiosis is associated with bacterial vaginosis (a condition characterized by an overgrowth of bacteria in the vagina), which leads to spontaneous preterm birth.
Bacterial vaginosis may be treated by administering antibiotics in severe cases. In addition, providing supplementary probiotics after treatment may normalize the pH of the vagina. It facilitates restoring cervicovaginal microbial balance, reducing inflammatory reactions that may cause preterm birth. However, studies have yet to confirm these exact benefits and are still ongoing to ensure the role of probiotics in preventing bacterial vaginosis and preterm birth.
Probiotic supplements should meet the criteria to ensure the user gets their benefits. Most probiotics are considered dietary supplements in the United States and are approved by the Food and Drug Administration (FDA). The formulation of each supplement brand may vary and contain single or multiple strains of the microorganism.
They may reduce susceptibility to the following conditions:
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Bacterial Vaginitis: It is a pain and inflammation of the vagina, mainly affecting women of childbearing age. It is due to the overgrowth of harmful or bad bacteria in the vaginal area. Frequent douching or unprotected sex can disturb the microbial balance in the vagina, leading to bacterial vaginitis.
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Yeast Vaginitis: It is a type of fungal infection. It results in irritation, pain, inflammation, itchiness, and discharge from the vagina due to yeast attacks in the area. It is caused by a type of yeast called candida.
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Urinary Tract Infection: Urinary tract infection, or UTI, is more likely to occur during pregnancy. It can lead to severe secondary infections in the mother. The condition may also affect the fetus.
Conclusion
Studies suggest a connection between cervicovaginal microbial imbalance and preterm birth. Certain studies prove the benefits of Lactobacillus species in maintaining the vaginal pH and decreasing the chance of preterm birth. Probiotic supplements help decrease the chances of bacterial and yeast vaginosis and urinary tract infections in pregnant women, reducing susceptibility to preterm birth. Extensive studies are still needed and ongoing to confirm the benefits of probiotic supplement consumption to prevent preterm birth.
