The relationship between gut microbiota and preterm premature rupture of membranes: Mechanisms of action and clinical applications.

Reza Ghotaslou, Maryam Alikamali, Javad Nezhadi, Somayeh Ahmadi

Journal: Microbial pathogenesis 2025;205():107673

PMID: 40339623

Abstract

Preterm Premature Rupture of Membrane (PPROM) constitutes a prevalent obstetric complication that markedly heightens the risk of neonatal mortality and low birth weight, while also potentially impacting the psychological well-being of the mother. Despite established associations between PPROM and various underlying medical conditions or lifestyle factor, a definitive treatment strategy continues to remain unattainable. Contemporary research indicates that dysbiosis of the gut microbiome may play a significant role in the pathogenesis of PPROM. Consequently, this study endeavors to gather recent findings related to the mechanisms underlying intestinal dysbiosis in relation to PPROM. It aims to offer novel insights into this critical issue. An increasing amount of evidence suggests that specific intestinal bacteria have the capacity to translocate into the vascular system and the amniotic cavity during pregnancy. This happens as a consequence of imbalances or dysbiosis within the gut microbiota. This translocation may be facilitated by the presence of bacteria within the amniotic cavity, modifications in the vaginal microbiota, and activation of the Hypothalamus-Pituitary-Adrenal (HPA) axis, which initiates a physiological cascade that accelerates the progression of PPROM. In light of these findings, the preservation of gut microbial homeostasis, particularly through the application of probiotics or dietary modifications, may serve to alleviate the detrimental effects of dysbiosis on PPROM.

Copyright © 2025. Published by Elsevier Ltd.

Address: Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: [email protected].; Kerman University of Medical Sciences, Kerman, Iran. Electronic address: [email protected].; Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: [email protected].; Department of Bacteriology and Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: [email protected].

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