What we’re working on: a look into labs of the March of Dimes Prematurity Research Centers
Our planet harbors a whole world of diverse and interdependent creatures and habitats. Likewise, but on a far different scale, our bodies are home to a class of exponentially more diverse and symbiotic species—our microbiome. Different communities of these bacteria, billions of them, live in different parts of our bodies, on our skin, in our gut, even in our reproductive organs, and these microbial communities, even at the same body site, can differ from person to person.
Normally, these microbial communities perform valuable and necessary functions we could not live without. However, when these communities get disrupted, it can lead to adverse health outcomes. The microbial communities in the cervicovaginal space have been shown to play a role in vaginal health and disease but their role in pregnancy has remained largely unknown until now. New research, funded by the March of Dimes and directed by Dr. Michal Elovitz, at the University of Pennsylvania Prematurity Research Center suggests that different microbiota living in the cervix and vagina play a key role in regulating the timing of structural changes these organs must undergo for birth to occur, normal or otherwise.
According to the research, just recently presented by Dr. Elovitz and her team, the cervicovaginal microbiota are significantly associated with spontaneous preterm birth. Furthermore, the research shows that there are certain microbiota associated with an increased risk of preterm birth—as well as different bacterial strains that actually help protect against it, and these specific bacteria may serve as new and promising therapies to reduce the incidence of preterm birth.
This finding represents a substantial departure in the traditional thinking about the key pathways for preterm birth and where they originate, a profound insight Dr. Elovitz has been developing over the last several years.
“The accepted wisdom used to be that the key pathway to preterm birth was the uterus,” Dr. Elovitz said. “But our research is showing that the focus on uterine contractions may not be the essential step to preventing preterm birth. The key pathway seems to be biological events that occur in the cervicovaginal space, and while this will need further study, our initial results are very promising.”
The cervix is a remarkable organ and not much is known about it and why it functions the way it does. What we do know is throughout pregnancy, the cervix is constantly adjusting to the weight of the baby, most likely through biomechanical and biochemical remodeling. Clinically, we know that the cervix must undergo a profound transformation during the processes of pregnancy and birth.
“What’s so amazing about the cervix is that, unlike other tissues, the cervix goes from a closed, rigid structure to a thin and almost non-palpable tissue to permit the birth of the baby, and then in a matter of minutes after delivery changes back again to a firm, solid organ to protect the mother,” said Dr. Elovitz. “Obstetricians and gynecologists have always known that these dynamic changes take place, but now we’re finding out there are biological factors, like the microbiome and inflammation that have a profound effect on that remodeling, including when it occurs.”
These are exciting new findings and Dr. Elovitz’s transdisciplinary team of Ob/Gyns, biomechanical engineers, orthopedic surgeons, microbiologists and others at the University of Pennsylvania Prematurity Research Center, are hopeful. Powerful new therapies based on this research may become realized much sooner than we ever dared hope.
For more information on prematurity research breakthroughs, we invite you to sign up for the Campaign to End Premature Birth newsletter.