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PLoS One. 2017 Oct 25;12(10):e0184336. doi: 10.1371/journal.pone.0184336. eCollection 2017.

Gut microbiome of mothers delivering prematurely shows reduced diversity and lower relative abundance of Bifidobacterium and Streptococcus.

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Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
University of Colorado School of Medicine, Colorado, United States of America.
Public Health Foundation of India, Gurgaon, India.
Department of Genetics and Genomic Sciences and Icahn Institute for Genomics & Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, United States of America.
Department of Medicine, Division of Clinical Immunology and Immunology Institute, Icahn School of Medicine at Mount Sinai, New York, United States of America.
Departments of Pediatrics and Computer Science & Engineering, University of California San Diego, San Diego, United States of America.
Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway.



Preterm birth is the main reason for neonatal deaths worldwide. We investigate whether maternal gut microbiota may play a previously overlooked role.


The Norwegian Microbiota Study (NoMIC) is a case control study on preterm birth (<259 days of gestation, calculated primarily based on the last menstrual period), including two consecutively born term infants per infant born prematurely. Eligible mothers were fluent in Norwegian and recruited from the maternity ward at a county hospital in Eastern Norway in the period 2002-2005. Fecal samples were collected at day 4 postpartum, and analyzed using 16S ribosomal RNA gene sequencing. We used samples from 121 mothers giving birth vaginally. Measures of alpha diversity (Shannon, Phylogenetic Diversity and Observed Operational Taxonomic Units) and microbiome composition were combined with information from the Medical Birth Registry, pregnancy journals, and questionnaires.


The association between maternal gut diversity and preterm delivery was examined using logistic regression. One IQR increase in Shannon diversity was significantly associated with 38% lower odds of spontaneous preterm birth, (95% confident interval (CI): 1%, 61%), and the association was stronger when adjusting for maternal age, marital status, ethnicity, parity, BMI, education, antibiotic use, pets in the household, income and smoking (48% lower odds, 95% CI: 4.2%, 72%). Mothers delivering prematurely also had lower abundance of OTUs belonging to Bifidobacterium and Streptococcus, and of the Clostridiales order.


Analysis of maternal gut microbiota using next-generation sequencing shows that low gut diversity, with a distinct microbial composition, is associated with spontaneous preterm delivery.

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