VAGINAL MICROBIOME AND THE RISK OF PRETERM BIRTH: PATHOPHYSIOLOGICAL MECHANISMS AND THERAPEUTIC PERSPECTIVES
DOI:
https://doi.org/10.36557/2674-9432.2026v5n1p3090-3100Palavras-chave:
Vaginal microbiome; Preterm birth; Dysbiosis; Inflammation;Resumo
The vaginal microbiome has been increasingly recognized as a key modulator of female reproductive health, playing a central role in maintaining genital tract homeostasis and protecting against ascending infections. The predominance of Lactobacillus species is associated with a stable vaginal environment, characterized by an acidic pH and the production of antimicrobial metabolites, which are essential for preventing colonization by pathogenic microorganisms. Disruptions in this composition, particularly the reduction of these beneficial microorganisms and the proliferation of anaerobic bactéria, define a state of vaginal dysbiosis, which has been consistently associated with adverse obstetric outcomes, notably preterm birth. This study aimed to analyze, through a narrative literature review, the main pathophysiological mechanisms linking the vaginal microbiome to the risk of prematurity, as well as to discuss emerging therapeutic perspectives in this field. The findings indicate that vaginal dysbiosis may trigger local and systemic inflammatory responses, facilitate the ascension of pathogens into the intrauterine environment, and compromise the integrity of fetal membranes, thereby promoting the premature onset of labor. Furthermore, individual, behavioral, and environmental factors are shown to modulate microbiome composition, rendering this interaction multifactorial and dynamic. Therapeutic strategies such as the use of probiotics, selective antibiotics, and personalized approaches based on microbial profiling have been investigated as promising alternatives for the prevention of prematurity. In conclusion, a deeper understanding of the vaginal microbiome represents a critical frontier in contemporary obstetrics, requiring integrated, individualized, and evidence-based clinical approaches.
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Copyright (c) 2026 Lívia de Oliveira Alves, Letícia de Oliveira Alves, Rodolfo de Oliveira Medeiros, Letícia Francisco de Azevedo, Bruna Muniz Gonçalves de Oliveira, Laís Melo Azevedo, Naomi Gabriela Kubo, João Alves dos Santos Mendes, Igor Soares Gianini Grecca, Sofia Oliveira Fabretti, Giovanna Yasmin da Silva Neves, Mariana Cantieri Martoneto, Maria Clara Bernini
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