# The Vaginal Microbiome and Racial Disparity in Preterm Delivery

> **NIH NIH R01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2020 · $709,046

## Abstract

Project Summary
Ascending infection is hypothesized to underlie a large but unknown fraction of preterm births.
The vaginal microbiome represents a physiological barrier to ascending infection through the
production of lactic acid by select organisms principally of the Lactobacillus genus. We
hypothesize that vaginal microbiota lacking sufficient Lactobacillus spp. (or others), have a
heightened susceptibility to ascending infection following the introduction of pathogenic
organisms, or the escalation in the relative proportion of seed pathogenic organisms (minor
constituents of the normal flora that multiply in permissive states). These susceptible
phenotypes may be over-represented among Blacks, or among women practicing specific
behaviors that disrupt the normal flora, like douching. We propose to discover what factors
influence these unfavorable vaginal microbiome profiles in an existing, diverse cohort of women
enrolled in the Pregnancy, Infection and Nutrition (PIN) study. PIN is a landmark longitudinal
investigation of the causes of prematurity among Blacks and Whites. Drawing from an existing
biobank including vaginal swabs collected at 24-29 weeks' gestation, we propose to: (1)
Examine the associations of the vaginal microbiome with spontaneous preterm birth (sPTB),
and explore whether these associations differ by maternal race; (2) Examine the influence of
innate sPTB risk factors, such as maternal polymorphisms in innate immunity genes and
maternal psychosocial stress and depression, on vaginal microbiome profiles overall and
stratified by race; and, (3) Examine the influence of exogenous risk factors for sPTB on vaginal
microbiome profiles, such as maternal nutritional patterns, maternal smoking, and other health
behavior. Furthermore, as an exploratory aim, we will conduct whole genome metagenome
sequencing in a subset of PTB cases enriched for an infectious etiology, with delivery before 32
completed weeks' gestation. A better understanding of the relationship between vaginal
microbial ecology and premature delivery is poised to offer new opportunities for primary
prevention, and the time is ripe to apply these methods to a racially diverse prenatal cohort.

## Key facts

- **NIH application ID:** 9855072
- **Project number:** 5R01MD011504-04
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Stephanie Engel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $709,046
- **Award type:** 5
- **Project period:** 2017-02-01 → 2023-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9855072

## Citation

> US National Institutes of Health, RePORTER application 9855072, The Vaginal Microbiome and Racial Disparity in Preterm Delivery (5R01MD011504-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9855072. Licensed CC0.

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