{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:06:30Z","timestamp":1777363590319,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T00:00:00Z","timestamp":1664323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010661","name":"Horizon 2020 Framework Programme","doi-asserted-by":"publisher","award":["Zixuan Xie received a fellowship from the European"],"award-info":[{"award-number":["Zixuan Xie received a fellowship from the European"]}],"id":[{"id":"10.13039\/100010661","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FIS PI15\/02043"],"award-info":[{"award-number":["FIS PI15\/02043"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012986","name":"Universidad Francisco de Vitoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012986","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Our objective was to compare the vaginal microbiome in low\u2010risk and high\u2010risk pregnant women and to explore a potential association between vaginal microbiome and preterm birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A pilot, consecutive, longitudinal, multicenter study was conducted in pregnant women at 18\u201322\u2009weeks of gestation. Participants were assigned to one of three groups: control (normal cervix), pessary (cervical length\u00a0\u226425\u2009mm) and cerclage (cervical length\u00a0\u226425\u2009mm or history of preterm birth). Analysis and comparison of vaginal microbiota as a primary outcome was performed at inclusion and at 30\u2009weeks of gestation, along with a follow\u2010up of pregnancy and perinatal outcomes. We assessed the vaginal microbiome of pregnant women presenting a short cervix with that of pregnant women having a normal cervix, and compared the vaginal microbiome of women with a short cervix before and after placement of a cervical pessary or a cervical cerclage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The microbiome of our control cohort was dominated by <jats:italic>Lactobacillus crispatus and inners<\/jats:italic>. Five community state types were identified and microbiome diversity did not change significantly over 10\u2009weeks in controls. On the other hand, a short cervix was associated with a lower microbial load and higher microbial richness, and was not correlated with <jats:italic>Lactobacillus<\/jats:italic> relative abundance. After intervention, the cerclage group (<jats:italic>n<\/jats:italic>\u00a0=\u00a019) had a significant increase in microbial richness and a shift towards community state types driven by various bacterial species, including <jats:italic>Lactobacillus mulieris<\/jats:italic>, unidentified <jats:italic>Bifidobacterium<\/jats:italic> or <jats:italic>Enterococcus<\/jats:italic>. These changes were not significantly observed in the pessary (<jats:italic>n<\/jats:italic>\u00a0=\u00a026) and control (<jats:italic>n<\/jats:italic>\u00a0=\u00a035) groups. The cerclage group had more threatened preterm labor episodes and poorer outcomes than the control and pessary groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings indicate that a short cervix is associated with an altered vaginal microbiome community structure. The use of a cerclage for preterm birth prevention, as compared with a pessary, was associated with a microbial community harboring a relatively low abundance of <jats:italic>Lactobacillus<\/jats:italic>, with more threatened preterm labor episodes, and with poorer clinical outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14460","type":"journal-article","created":{"date-parts":[[2022,9,28]],"date-time":"2022-09-28T08:49:28Z","timestamp":1664354968000},"page":"1403-1413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes"],"prefix":"10.1111","volume":"101","author":[{"given":"Mireia","family":"Vargas","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Maternal\u2010Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisca","family":"Ya\u00f1ez","sequence":"additional","affiliation":[{"name":"Maternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Elias","sequence":"additional","affiliation":[{"name":"Maternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Bernabeu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Maternal\u2010Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Department of Reproductive Medicine Instituto Bernabeu  Alicante Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4001-2017","authenticated-orcid":false,"given":"Maria","family":"Goya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Maternal\u2010Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Microbiome Lab Hospital Universitario Vall d'Hebron; Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD); Department of Medicine, Universitat Aut\u00f2noma de Barcelona  Cerdanyola del Vall\u00e8s Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zixuan","family":"Xie","sequence":"additional","affiliation":[{"name":"Maternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2100-7693","authenticated-orcid":false,"given":"Alba","family":"Farr\u00e1s","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Maternal\u2010Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Microbiome Lab Hospital Universitario Vall d'Hebron; Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD); Department of Medicine, Universitat Aut\u00f2noma de Barcelona  Cerdanyola del Vall\u00e8s Spain"},{"name":"Women and Perinatal Health Research Group Institut d'Investigaci\u00f3 Biom\u00e8dica de Sant Pau (IIB\u2010Sant Pau). Hospital Universitari de Sant Pau  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zaida","family":"Soler","sequence":"additional","affiliation":[{"name":"Maternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Blasquez","sequence":"additional","affiliation":[{"name":"Maternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonor","family":"Valle","sequence":"additional","affiliation":[{"name":"Maternal\u2010Fetal Medicine Unit, Department of Obstetrics Hospital Universitario Materno\u2010Infantil de Canarias  Las Palmas de Gran Canaria Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Olivella","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Hospital de Sant Pau  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bego\u00f1a","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Hospital Universitari Sant Joan de Reus  Reus Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1840-5087","authenticated-orcid":false,"given":"Maia","family":"Brik","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Hospital Universitario de Torrej\u00f3n, Universidad Francisco de Vitoria  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Carreras","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Maternal\u2010Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"},{"name":"Microbiome Lab Hospital Universitario Vall d'Hebron; 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