The role of host-microbial interactions in altering preterm birth risk among black women

In the United States, approximately 400,000 infants are born preterm each year, contributing to an infant mortality rate worse than that of 26 other economically developed countries. Preterm birth (PTB) risk is not evenly distributed across American society, with Black women experiencing a 50% higher risk than white women, a disparity not explained by genetic variation alone. Our study was designed to rigorously advance the field by investigating the role of the CV microbiota in a large, well-phenotyped sPTB cohort, with a focus on addressing disparities by prioritizing additional research in Black women. Our aims were to uncover novel biological mechanisms in sPTB, including: 1) whether specific CSTs are associated with molecular signatures of premature cervical remodeling; and 2) whether high-risk CV microbial-immune profiles are present prior to pregnancy, and how pregnancy may shift women into favorable or unfavorable states. By addressing these critical knowledge gaps, we provide new insights into potential windows for intervention and identify host and microbial modifiers of high-risk CV states, findings that could ultimately help reduce the burden of sPTB among Black women.