A Specific Bacterial DNA Signature in the Vagina of Australian Women in Mid-Pregnancy Predicts High Risk of Spontaneous Preterm Birth (The Predict1000 Study).

Abstract Background Intrauterine infection accounts for about one quarter of cases of spontaneous preterm birth (sPTB); however, at present it is not possible to efficiently identify pregnant women at risk in order to deliver preventative treatments. Objective To establish a vaginal microbial DNA test for Australian women in mid-pregnancy that will identify those at increased risk of sPTB. Study design 1000 women with singleton pregnancies were recruited in Perth, Australia. Mid-vaginal swabs were collected between 12- and 23-weeks’ gestation. DNA was extracted for detection of 23 risk-related microbial DNA targets by qPCR. Obstetric history, pregnancy outcome and demographics were recorded. Results After excluding 64 women due to losses to follow-up and insufficient sample for microbial analyses, the final cohort consisted of 936 women of predominantly Caucasian ethnicity (74.3%). The overall PTB rate was 12.6% (118 births); the sPTB rate Conclusions We have identified a vaginal bacterial DNA signature that identifies women with a singleton pregnancy who are at increased risk of sPTB and may benefit from targeted antimicrobial therapy.