# THE VAGINAL MICROBIOME, MATERNAL RESPONSE, AND PRETERM BIRTH

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2020 · $659,444

## Abstract

ABSTRACT
An estimated 13 million preterm births (PTBs) occur annually worldwide, and PTB is the single most
significant contributing factor to neonatal morbidity and mortality. Mechanisms underlying preterm
birth are unknown hampering development of effective prediction and prevention strategies. PTB is
linked to local and distant infections and recent data suggests that vaginal bacterial microbiome early
in pregnancy is associated with subsequent preterm birth. Viral infections behave differently during
pregnancy, with common viral infections such as varicella and influenza causing much more severe
disease during pregnancy and human papillomavirus, the causative virus in cervical cancer,
associated with a 2-fold increased risk for PTB. However, comprehensive assessment of vaginal viral
communities during pregnancy has not been performed. Lastly, although maternal inflammation is
one of the leading triggers for PTB the precise constellation of inflammatory signals is not known. We
propose that examining microbial communities or host response alone is incomplete, but that their
combination will lead to refined definitions of appropriate and inappropriate microbe-maternal biology
and shed new light on the old problem of PTB.
Our central hypothesis is that preterm birth can be estimated by a combination of three criteria:
vaginal bacterial communities, vaginal eukaryotic viral communities, and maternal
inflammatory response. We have an interdisciplinary team assembled including perinatologists,
epidemiologists, virologists, and genomics informatics experts, leveraging the unique capabilities of
the McDonnell Genome Institute at Washington University in St. Louis, a well-established pregnancy
bio-specimen and clinical data infrastructure, and a high-PTB burdened racially diverse patient
population to test this novel hypothesis.
The aims of this project are: 1) Determine the ability of bacterial and viral communities in the vagina
and their dynamics over time to predict preterm birth 2) Determine the ability of the host inflammatory
response in the vagina in the context of microbial communities to predict preterm birth. The proposed
research is innovative, for the first time, comprehensively characterizing the eukaryotic vaginal virome
simultaneously with vaginal bacterial communities and longitudinally capturing the maternal response
to these communities. We employ an efficient study design, a well-established research
infrastructure, and renowned genome sequencing expertise to test a physiologically plausible but
uninvestigated paradigm that bacterial and viral communities in concert with the maternal host
response can predict PTB.

## Key facts

- **NIH application ID:** 9993632
- **Project number:** 5R01HD095986-03
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Molly Stout
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $659,444
- **Award type:** 5
- **Project period:** 2018-09-12 → 2023-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9993632

## Citation

> US National Institutes of Health, RePORTER application 9993632, THE VAGINAL MICROBIOME, MATERNAL RESPONSE, AND PRETERM BIRTH (5R01HD095986-03). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9993632. Licensed CC0.

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