REVIEW article
Front. Immunol.
Sec. Microbial Immunology
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1642942
This article is part of the Research TopicHost-Microbiota Immuno-Interactions for Personalized Microbial TherapeuticsView all 10 articles
Interaction of vaginal microbiota and biomarkers in Premature rupture of membranes: from bench to beside
Provisionally accepted
- 1Jilin University, Changchun, China
- 2The Second Hospital of Jilin University, Changchun, China
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Preterm premature rupture of membranes (PROM) is a critical obstetric complication endangering maternal and neonatal health, with growing evidence linking vaginal microecology to its pathogenesis. This review synthesizes the relationship between vaginal microbiota and PROM risk, as well as microecology-targeted prevention and management strategies. A balanced vaginal microbiome, dominated by lactobacilli that maintain an acidic protective environment, is essential for reproductive health. Dysbiosismarked by reduced lactobacilli and increased pathogens like Gardnerella and Atopobiumimpairs local immunity, weakens fetal membranes, and elevates PROM risk, with bacterial vaginosis (BV) strongly associated with this condition. Pathogenic overgrowth activates inflammatory (via TLR-mediated IL-1 β , TNFα , IL-6 overproduction) and oxidative stress pathways: pro-inflammatory cytokines promote cervical ripening, induce matrix metalloproteinases (MMPs) to degrade fetal membrane collagen, while reactive oxygen species (ROS) directly damage structural proteins, compromising membrane integrity. Monitoring inflammatory/oxidative stress biomarkers (e.g., cytokine levels, ROS activity) enables early risk assessment. Potential interventions include probiotics to restore microbial balance, antioxidants/immunomodulators to counteract stress/inflammation, and MMP inhibitors to preserve membrane structure, all aiming to improve pregnancy outcomes. In conclusion, vaginal microecology plays a pivotal role in PROM development, underscoring the need for early microecological monitoring. Future research should dissect mechanistic complexities and develop precision tools for preterm labor management.Premature rupture of membranes (PROM), especially when it happens prior to 37 weeks of gestation, is a common and significant pregnancy complication that impacts a considerable number of expectant mothers globally(2020). The incidence of preterm premature rupture of membranes (PPROM) frequently results in early labor, which may lead to various negative perinatal consequences, such as neonatal respiratory distress syndrome, sepsis, necrotizing enterocolitis, and developmental disorders in infants (Clark and Varner, 2011). These conditions significantly impact neonatal survival rates and
Keywords: Preterm premature rupture of membranes (PROM), Vaginal microecology, Bacterial vaginosis (BV), Inflammation, Oxidative Stress
Received: 07 Jun 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 邓, Wu, 李 and 刘. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fuju Wu, The Second Hospital of Jilin University, Changchun, China
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