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Being born too early or being born too small is the largest cause of neonatalmortality in the world. Compared to the rest of the world, Malawi has one ofthe largest burdens of preterm birth and neonatal stunting, with infectionrecognised as an important risk factor. Previous studies have used cultureand molecular methods to identify bacteria that could be responsible fortriggering labour and foetal growth restriction. The composition of the oraland vaginal microbiome has also been linked as the possible source of thesebacteria. However, studies up to this point have been small and have not utilised the full potential of current sequencing technologies. In this study, we wanted to demonstrate using high-throughput sequencing of the 16S rRNA gene that certain organisms are associated with adverse birth outcomes. Contaminating bacterial taxa, PCR and sequencing error can be filtered post-sequencing to allow reliable reconstruction of microbial communities from low biomass samples such as the placenta. This revealed a specific community structure in the placenta and foetal membranes associated with severe chorioamnionitis. The results from this study provide further evidence of the important role the vaginal microbiome may play in seeding organisms found on placental tissues and therapeutic interventions could be designed to impact these communities with the goal of reducing the risk of preterm birth or intrauterine growth restriction. |