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At GTP1, the preterm-delivered women showed abundant <jats:italic>G. vaginalis<\/jats:italic> (AUC\u2009=\u20090.77) over <jats:italic>L. crispatus<\/jats:italic> and <jats:italic>L. iners<\/jats:italic>, and upregulation of 10 metabolites. At GTP2, the same women had more lactobacilli- and mixed anaerobes-dominated microbiota, upregulation of five metabolites, and decreased TNFR1, distinguishing them from their term counterparts (AUC\u2009=\u20090.88). From GTP1 to GTP2, sPTB was associated with increased microbiota \u03b1-diversity, and upregulation of pantothenate and urate. CXCL10 declined in the term-delivered women by ~3-fold, but increased in the preterm-delivered women (AUC\u2009=\u20090.68), enhanced by FFN (AUC\u2009=\u20090.74). Characterising the complex dynamic interactions between cervicovaginal microbial metabolites and host immune responses could enhance sPTB risk stratification.<\/jats:p>","DOI":"10.1038\/s41522-025-00671-4","type":"journal-article","created":{"date-parts":[[2025,3,26]],"date-time":"2025-03-26T05:54:30Z","timestamp":1742968470000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Vaginal host immune-microbiome-metabolite interactions associated with spontaneous preterm birth in a predominantly white cohort"],"prefix":"10.1038","volume":"11","author":[{"given":"Megan","family":"Cavanagh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Amabebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neha S.","family":"Kulkarni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria D.","family":"Papageorgiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Walker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew D.","family":"Wyles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2502-3033","authenticated-orcid":false,"given":"Dilly O.","family":"Anumba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,26]]},"reference":[{"key":"671_CR1","doi-asserted-by":"publisher","first-page":"132ra152","DOI":"10.1126\/scitranslmed.3003605","volume":"4","author":"P Gajer","year":"2012","unstructured":"Gajer, P. et al. 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