Vaginal Dysbiosis - Associations with chromosomally normal miscarriage

Miscarriage, defined as pregnancy loss before the fetus reaches viability, is a distressing disorder associated with pain and bleeding as well as a devasting psychological outcome. 50% of early miscarriages (pregnancy loss before 12 weeks) are associated with chromosomal abnormalities, but that leaves 50% of women with no clear explanation of what might have contributed to their loss. Despite its prevalence, there are no interventions that prevent sporadic miscarriage and only a few treatments, such as progesterone supplements, have been shown to modestly reduce the recurrence risk of miscarriage in subsequent pregnancies.

Emerging evidence implicates the vaginal microbiome as a key modulator of local inflammatory and immune pathways throughout pregnancy.

A recent research trial investigated the role that the vaginal microbiome may play in women that had experienced pregnancy loss. The women who had a miscarriage were tested for chromosol abnormalities. They found that in pregnancies that were chromosomally normal, miscarriage was associated with a vaginal microbiome that was low in Lactobacillus species. The data suggest the vaginal microbiota plays an important aetiological role in euploid miscarriage and may represent a target to modify the risk of pregnancy loss. The reason that this is important research is that testing, intervening, and taking care of the vaginal microbiome is something that can be done pre-pregnancy to help to improve pregnancy outcomes.

https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-021-02227-7?ct=t(TSJ_115)&goal=0_ce350f41fb-648c1bd44a-112521485&mc_cid=648c1bd44a&mc_eid=9e20d68a23