Bacterial profiles of the human placenta from term and preterm deliveries

Abstract

Whether the human placenta is a sterile organ is under debate. Yet, infection of the amniotic cavity, including the placenta, is causally linked to preterm birth. This study compares the bacterial profiles of term and preterm placentas through culture and 16S rRNA gene sequencing of the amnion, amnion-chorion interface, subchorion, villous tree, and basal plate, while accounting for patient identity, mode of delivery, presence/absence of labor, and potential background DNA contamination. As no evidence of a placental microbiota in term pregnancy was found, these placentas were considered as controls. Placentas from preterm birth cases were more likely to yield bacterial cultures, and their bacterial DNA profiles were less rich than those of term controls, suggesting the predominance of only a few bacteria. Nevertheless, the bacterial DNA profiles of placentas from preterm cases and term controls were not consistently different. The placentas from preterm cases may often have a microbiota but the bacteria constituting these communities varied among the women. Mode of delivery had a pronounced effect on the bacterial profiles of all sampled levels of the placenta. Specifically, the bacterial DNA profiles of vaginally delivered placentas had higher relative abundances of Finegoldia, Gardnerella, Peptoniphilus, and Prevotella (each a common resident of the vaginal microbiota) than the profiles of cesarean-delivered placentas. Collectively, these data indicate that there is a not a placental microbiota in normal term pregnancy, and that although the placentas of some preterm cases were populated by bacteria, the identities of these bacteria varied among women delivering preterm. IMPORTANCEIf a placental microbiota exists, then current understanding of the roles of microorganisms in pregnancy outcomes need to be reconsidered. For instance, we will need to determine if a placental microbiota is beneficial to pregnancy outcome by excluding potential pathogens from colonizing the placenta and/or effectively priming the fetal immune system, and furthermore which characteristics of the placental microbiota preclude versus promote placental infection, which can result in pregnancy complications such as preterm birth. Our findings here are consistent with prior investigations that have reported that there is not a placental microbiota in typical human pregnancies. Yet, bacteria can be detected in placentas from preterm deliveries. The principal source of microorganisms invading the amniotic cavity, including the placenta, is the vaginal microbiota. Focus should be on elucidating the metabolic and/or virulence characteristics of the subset of bacteria within the vaginal microbiota that commonly invade the amniotic cavity, resulting in infection.