# Vaginal Microbiome and Metabolites in Preterm Birth

> **NIH NIH K23** · JOHNS HOPKINS UNIVERSITY · 2022 · $197,892

## Abstract

PROJECT SUMMARY/ABSTRACT
This proposal presents a five year research career development program focused on the study of vaginal
microbiome contributions to preterm birth among women with HIV to expand the breadth and depth of
understanding of vaginal dysbiosis in preterm birth (PTB). The candidate is currently an Assistant Professor of
Gynecology and Obstetrics at Johns Hopkins University School of Medicine. The outlined proposal builds on
the candidate’s previous research and clinical experience in pregnancy outcomes among women with HIV and
integrates two new domains of expertise of her mentors, Drs. Irina Burd and Khalil Ghanem at Johns Hopkins:
inflammatory pathways leading to PTB with vaginal microbiome research. The proposed experiments and
didactic work will position the candidate with a unique set of cross disciplinary skills that will enable her to
transition to independence as a physician scientist with expertise in cohort study design and microbiome
bioinformatics.
Bacterial vaginosis (BV), an alteration in the vaginal microbiome, nearly doubles the risk of preterm birth,
delivery prior to 37 weeks, and affects one third of women of reproductive age. In the US, women with HIV
experience a two-fold increased risk of PTB compared to women without HIV. Women with HIV who have a
Lactobacilus-deficient/ anaerobe-dominant vaginal microbiota have increased vaginal inflammation, higher
genital HIV viral load and increased HIV viral shedding. The lacking data in US-based pregnant women with
HIV risk perpetuating significant healthcare disparities. It is unknown whether the underlying mechanism
between HIV infection and PTB is driven by vaginal dysbiosis. The foundation of this proposal is based on prior
data documenting vaginal dysbiosis as a potential driver for altered inflammatory pathways and adverse
pregnancy outcomes, particularly among African American women. Women with HIV and vaginal dysbiosis
have increased risk for genital mucosa inflammation and viral shedding. The role of vaginal dysbiosis in
pregnancy among women with HIV has not been explored to date, nor have the effects of ART on the vaginal
microbiome in pregnancy. Specifically, this proposal aims to: 1) compare the structure (relative and absolute
abundance) and composition (diversity) of the vaginal microbiota of pregnant women with HIV who experience
PTB versus term birth, 2) determine the extent to which vaginal microbiota function, measured by median
difference in metabolites (short chain fatty acids), correlates with PTB, and 3) measure and compare cervico-
vaginal concentrations of soluble inflammatory mediators (antimicrobial peptides and pro-inflammatory
cytokines) in PTB. The scientific objective of this proposal is to begin to define the strength of the association
between vaginal microbiota, markers of mucosal inflammation and PTB among women with HIV and generate
hypotheses that inform the direction and design of subsequent studies focused on potential interventio...

## Key facts

- **NIH application ID:** 10466813
- **Project number:** 5K23AI155296-02
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Anna Maya Powell
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $197,892
- **Award type:** 5
- **Project period:** 2021-08-10 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10466813

## Citation

> US National Institutes of Health, RePORTER application 10466813, Vaginal Microbiome and Metabolites in Preterm Birth (5K23AI155296-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10466813. Licensed CC0.

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