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Caitriona Brennan Department of Pediatrics, University of California San Diego, La Jolla, California, USA
Division of Biological Sciences, University of California San Diego, La Jolla, California, USA

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Kristina Chan Department of Pediatrics, University of California San Diego, La Jolla, California, USA
Department of Bioengineering, University of California, San Diego, La Jolla, California, USA

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Tanya Kumar Medical Scientist Training Program, University of California San Diego, La Jolla, California, USA

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Erica Maissy Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, California, USA

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Linda Brubaker Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California, USA

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Marisol I Dothard Department of Pediatrics, University of California San Diego, La Jolla, California, USA
Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, California, USA

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Jack A Gilbert Department of Pediatrics, University of California San Diego, La Jolla, California, USA
Center for Microbiome Innovation, University of California San Diego, La Jolla, California, USA

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Katharine E Gilbert Department of Pediatrics, University of California San Diego, La Jolla, California, USA

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Amanda L Lewis Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California, USA

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Varykina G Thackray Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California, USA
Center for Microbiome Innovation, University of California San Diego, La Jolla, California, USA

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Amir Zarrinpar Department of Bioengineering, University of California, San Diego, La Jolla, California, USA
Medical Scientist Training Program, University of California San Diego, La Jolla, California, USA
Division of Gastroenterology, University of California San Diego, La Jolla, California, USA
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego, La Jolla, California, USA
Center for Microbiome Innovation, University of California San Diego, La Jolla, California, USA
Jennifer Moreno Department of Veterans Affairs Medical Center, La Jolla, California, USA
Institute of Diabetes and Metabolic Health, University of California San Diego, La Jolla, California, USA

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Rob Knight Department of Pediatrics, University of California San Diego, La Jolla, California, USA
Department of Bioengineering, University of California, San Diego, La Jolla, California, USA
Center for Microbiome Innovation, University of California San Diego, La Jolla, California, USA
Department of Computer Science and Engineering, University of California, San Diego, La Jolla, California, USA
Halıcıoğlu Data Science Institute, University of California San Diego, La Jolla, California, USA

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-specific disease. The vaginal microbiota’s community composition has been classified into five unique community state types (CSTs), several of which are dominated by lactic acid-producing bacteria belonging to the Lactobacillus genus ( Ravel et al. 2011 , Kwon

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Kei Odawara Obstetrics and Gynecology in the Department of Surgery, Showa University, Shinagawa-ku, Tokyo, Japan
Obstetrics and Gynecology, Showa University, Shinagawa-ku, Tokyo, Japan
Fertility Clinic Tokyo, Shibuya-ku, Tokyo, Japan

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Ryosuke Akino Obstetrics and Gynecology in the Department of Surgery, Showa University, Shinagawa-ku, Tokyo, Japan

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Akihiko Sekizawa Obstetrics and Gynecology in the Department of Surgery, Showa University, Shinagawa-ku, Tokyo, Japan

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Miwa Sakamoto Obstetrics and Gynecology, Showa University, Shinagawa-ku, Tokyo, Japan

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Seo Yuriko Fertility Clinic Tokyo, Shibuya-ku, Tokyo, Japan

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Kanako Tanaka Fertility Clinic Tokyo, Shibuya-ku, Tokyo, Japan

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Mutsumi Mikashima Fertility Clinic Tokyo, Shibuya-ku, Tokyo, Japan

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Masami Suzuki Fertility Clinic Tokyo, Shibuya-ku, Tokyo, Japan

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Yasushi Odawara Fertility Clinic Tokyo, Shibuya-ku, Tokyo, Japan

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et al. reported that the bacterial microbiota in the vaginal and intrauterine areas was independent ( Moreno et al. 2016 , Moreno & Simon 2018 ). Furthermore, Chen et al. examined the bacterial microbiota present in the vaginal and fallopian

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Carlos H Miyashira Centro de Ensaios Clinicos, Fundação Butantan, São Paulo, Sao Paulo, Brazil

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Fernanda Reali Oliveira Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil

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Marina Paula Andres Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
Gynecologic Division, BP – A Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Sao Paulo, Brazil

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Julian A Gingold OB/GYN and Women’s Health, Division of Reproductive Endocrinology and Infertility, Montefiore Medical Center, Bronx, New York, USA

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Mauricio Simões Abrão Departamento de Obstetricia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Sao Paulo, Brazil
Gynecologic Division, BP – A Beneficencia Portuguesa de Sao Paulo, Sao Paulo, Sao Paulo, Brazil

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-inflammatory cytokines and activation of antigen-presenting cells through lipopolysaccharide (LPS) pathways ( Cani 2018 ). Also, studies have shown that the fecal and vaginal microbiota are correlated and that the use of probiotics can impact both the fecal and vaginal

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Emmanuel Amabebe Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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Steven Reynolds Academic Unit of Radiology, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK

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Dilly O C Anumba Academic Unit of Reproductive and Developmental Medicine, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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The connection between vaginal microbiota-metabolite profiles and preterm delivery (PTD, birth <37 weeks’ gestation) has been a topical subject. Previous research has focused on specific metabolites using proton NMR spectroscopy ( 1 H

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Emmanuel Amabebe Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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Noopur Bhatnagar Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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Nitin Kamble School of Dentistry, University of Sheffield, Sheffield, UK

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Steven Reynolds Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK

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Dilly O Anumba Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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debilitating morbidity in surviving infants ( Suff et al. 2019 ). Majority (70%) of PTBs occur spontaneously with significant contribution from ascending genital tract infections and inflammation ( Romero et al. 2014 ). A dysbiotic vaginal microbiota can

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Emmanuel Amabebe Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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Dilly O Anumba Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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. 2017 ). The vaginal microbiota at late gestation is similar to that of a non-pregnant (non-menstruating and bacterial vaginosis, BV-negative) state characterised by a decrease in α-diversity (species richness – within individual diversity or amount of

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Francesca Hearn-Yeates EXPPECT Edinburgh and Centre for Reproductive Health, University of Edinburgh, Institute for Regeneration and Repair, Edinburgh, UK

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Andrew W Horne EXPPECT Edinburgh and Centre for Reproductive Health, University of Edinburgh, Institute for Regeneration and Repair, Edinburgh, UK

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Siobhain M O’Mahony Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
APC Microbiome Ireland, University College Cork, Cork, Ireland

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Philippa T K Saunders EXPPECT Edinburgh and Centre for Reproductive Health, University of Edinburgh, Institute for Regeneration and Repair, Edinburgh, UK

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, such as abdominal bloating and those mirroring irritable bowel syndrome (IBS) ( Saunders & Horne 2021 , Saunders & Horne 2023 ). The gut microbiota is the collection of bacteria, viruses, and archaea within the gastrointestinal (GI) tract which

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Noble K Kurian Department of Microbiology, Atmiya University, Rajkot, Gujarat, India

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Deepak Modi Molecular and Cellular Biology Laboratory, ICMR-National Institute for Research in Reproductive Health and Child Health (NIRRCH), Indian Council of Medical Research (ICMR), Mumbai, India

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2012 ). Using culture-independent methods and molecular phylogenetic approaches, distinct differences in the vaginal microbiota have been observed in women who delivered preterm as compared to those delivered at term ( Romero et al. 2014 ). Recently

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S M O’Mahony Department of Anatomy and Neuroscience, University College Cork, Cork, Ireland
APC Microbiome Ireland, University College Cork, Cork, Ireland

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P Comizzoli Smithsonian’s National Zoo and Conservation Biology Institute, Washington, District of Columbia, USA

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://doi.org/10.1016/j.tree.2019.11.004 ) Russell AL McAdams ZL Donovan E Seilhamer N Siegrist M Franklin CL & Ericsson AC 2023 The contribution of maternal oral, vaginal, and gut microbiota to the developing offspring gut . Scientific Reports

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Emmanuel Amabebe Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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Henry Ogidi Department of Obstetrics and Gynaecology, Glan Clwyd Hospital North Wales, Gwynedd, UK

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Dilly O Anumba Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK

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Origin Subepithelial stroma Epithelial cells Read et al. (2007), Timmons et al. (2010), Mahendroo (2012) Stimulus Progesterone withdrawal, complement activation Altered vaginal microbiota, HPV infection Gonzalez et al. (2011 a , b

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