Is the Vaginal Microbiome and Metabolome Associated With Spontaneous Preterm Birth (sPTB) in Multiple Pregnancies?

When a woman is pregnant with twins, there's a higher chance of the babies being born earlier than expected. This is called preterm birth. Sadly, being born very early can sometimes lead to serious health problems for babies, affecting their brain, lungs, and gut, which can result in lifelong disabilities. The earlier babies are born, the greater the risk of these problems. While doctors have some ways to predict early births in pregnancies with one baby, these methods don't seem to work as well for twin pregnancies, and at the moment, there aren't many treatments that can reliably stop twins from being born too soon.

Every woman has a collection of tiny living things, like bacteria and yeasts, in her vagina. These are completely normal. Recent research has shown that these tiny organisms can change during pregnancy and might be connected to when a woman goes into labour. However, all the previous research on this has only been done with pregnancies where there's just one baby. We want to find out if these vaginal organisms play a role in twin pregnancies.

In this study, we want to see if there are particular patterns of these vaginal organisms in twin pregnancies that deliver too early, compared to those that go to full term. We’ll also be looking at blood samples and measuring how 'stiff' the cervix (the neck of the womb) is, as these might also offer clues about preterm birth. By collecting all this information, we hope to understand more about why some twin pregnancies result in early births. Our ultimate goal is to find better ways to predict which twin pregnancies are at risk and, in the future, to develop new treatments to prevent early births in twins.