Microbial Bioactives
Microbial Bioactives | Online ISSN 2209-2161
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Volume 5 Number 1 2022
REVIEWS (Open Access)
Interwoven Ecosystems: The Vaginal Microbiome’s Role in Cervical Cancer and Preterm Birth — A Systematic Review and Meta-Analytic Introduction
Anwar Ullah 1*
Microbial Bioactives 5 (1) 1-8 https://doi.org/10.25163/microbbioacts.5110701
Submitted: 20 January 2022 Revised: 16 March 2022 Accepted: 23 March 2022 Published: 25 March 2022
Abstract
Cervical cancer and preterm birth remain major global reproductive health challenges, significantly impacting maternal and neonatal outcomes. Emerging evidence implicates the vaginal microbiome as a critical determinant in the pathogenesis of both conditions. This systematic review and meta-analysis synthesize current knowledge on how microbial composition, particularly the dominance or depletion of Lactobacillus species, influences cervical health and pregnancy outcomes. Healthy vaginal ecosystems, typically dominated by Lactobacillus crispatus, L. gasseri, and L. jensenii, maintain an acidic environment, produce antimicrobial metabolites, and modulate mucosal immunity to prevent pathogenic overgrowth. Conversely, dysbiotic states characterized by bacterial vaginosis, with overrepresentation of anaerobic species such as Gardnerella vaginalis, Atopobium vaginae, and Prevotella spp., compromise epithelial integrity, disrupt immune responses, and facilitate the persistence of high-risk human papillomavirus (HPV) infections. Meta-analytic data indicate that these dysbiotic profiles correlate with increased risks of persistent HPV infection, cervical dysplasia, and adverse pregnancy outcomes including preterm birth and intrauterine infection. Mechanistically, microbial biofilms, enzymatic activity, and immune modulation collectively underpin these associations. The findings highlight the potential of microbiome-based interventions, including probiotics and targeted antimicrobial therapies, to restore vaginal eubiosis and reduce disease burden. Integrating microbial, immunological, and clinical data into predictive models offers a promising avenue for improving reproductive health outcomes globally.
Keywords: vaginal microbiome, cervical cancer, preterm birth, bacterial vaginosis, Lactobacillus, dysbiosis, HPV, maternal-fetal health
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