Fig. 4

Vaginal dysbiosis is associated with increased risk of chorioamnionitis with funisitis following PPROM. a Differentially abundant vaginal taxa detected using LEfSe analysis in samples taken prior to delivery in women with normal histology or chorioamnionitis with funisitis. b The vaginal microbiome of patients with normal histology was enriched with Lactobacillus spp. whereas those with chorioamnionitis with funisitis were enriched with Fusobacteriales including Sneathia, Bacteroidales, Peptostreptococcus and Catonella species. c Increased prevalence of Lactobacillus depleted/dysbiotic communities with significantly reduced Lactobacillus abundance was observed in the chorioamnionitis with funisitis cohort (P = 0.0025, Fisher’s exact). d No difference was detected in vaginal microbial richness between groups. However, e diversity was increased in cases complicated by chorioamnionitis with funisitis. f Bacterial load was comparable between histological groups. g, h Serum markers of maternal infection and inflammation were significantly elevated in cases of chorioamnionitis, +/- funisitis (CRP: P = 0.000016, WCC: P = 0.0016). i, j Both WCC (rho = 0.54, P = 0.0001) and CRP (rho = 0.45, P =0.0013) were positively correlated with vaginal bacterial alpha diversity. CRP C-reactive protein, LDA latent discriminatory analysis, LEfSe linear discriminant analysis with effect size; WCC white cell count