A new scientific innovation can help medical practitioners assess pregnancy risks much more efficiently. In a study published last week in Nature Communications, researchers explained that a new vaginal swab test could analyze vaginal microbiomes to detect and prevent pregnancy risks like bacterial infections, preterm births, and so on.
“There exists a need for rapid, point-of-care vaginal diagnostics to facilitate faster clinical decision making, more judicious use of antibiotics, and targeted treatment strategies,” the paper stated.
The test can analyze results within three minutes, which is eight hours faster than current technology permits. It can also detect inflammation, which is a marker of infection. This is significant. Bacterial infections which ascend the vaginal canal into the cervix during pregnancy can cause preterm births and pregnancy loss.
Globally, infection preterm births are the leading cause of death in children. The general risk of preterm birth also exceeds 10% worldwide, with marginalized people disproportionately bearing the brunt of this figure.
The new test allows doctors to identify these risk factors earlier and monitor people more closely, administering preventive treatments if necessary. In other words, earlier and efficient testing can be life-saving.
“We’ve known for some time that the vaginal microbiome can contribute to the risk of preterm birth, but now we have developed a device which in just a few minutes can report both the microbiome composition and inflammatory status of a sample collected during pregnancy,” said Dr. David MacIntyre, an author of the paper from Imperial College London.
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The study, which analyzed over 1,000 samples from 400 pregnant women, found that more diverse microbiome profiles indicated higher rates of preterm births and inflammation. According to the study, when a bacteria called Lactobacillus crispatus is abundant, this is a good sign. When other microbes enter the scene and deplete this bacterium species, bacterial vaginosis isn’t a good sign. Using the test, doctors can now detect a reduction in Lactobacillus crispatus to identify complication risks earlier.
Notably, the test was also responsible for finding out that a procedure commonly used to prevent preterm births was itself causing preterm births. This procedure was the cervical stitch, or the “cervical cerclage” treatment, which causes bacterial infections that increase the likelihood of preterm births.
More specifically, “braided” instead of monofilament material for the cerclage treatment “can induce vaginal bacterial dysbiosis, inflammatory activation and premature cervical ripening associated with increased risk of preterm birth,” the paper states.
However, the researchers caution that the test only identifies one of the many risk factors associated with preterm births.
But the research is significant because compared with other types of microbiomes, such as the gut, vaginal microbiomes are relatively understudied. As recently as last year, researchers from the University of Maryland “decoded” vaginal microbiomes by creating a tool to map them in high resolution, allowing future treatments and diagnostic tests to be more efficient. Another researcher, who in 2012 cataloged all the bacteria species in the vagina and had been working to “fill in the dark matter” on the subject, said, “[the tool] not only addresses who is there in the [bacterial] community but also what are they doing.”
The test could also have broader applications to other aspects of health in which scientists implicate vaginal microbiomes. These include HIV, HPV, IVF failure, and miscarriages. A 2019 study associated greater diversity of vaginal microbiomes with genital infections.
“An unhealthy microbiome is an important cause of preterm birth that, currently, we have no way of diagnosing or treating. The introduction of this test into research studies, and clinical practice, should have a dramatic effect on our ability to prevent these preterm births and could have wider applications in other areas such as miscarriage and prevention of cervical cancer,” said Phillip Bennett, another author, and Imperial College researcher.
