The role of the vaginal microbiome and cervical length at 16 weeks in the prediction of preterm birth in twin pregnancy

Being born earlier than expected (preterm birth) happens in 50-60% of twin pregnancies and carries risks of stillbirth or harm to the babies. There are a number of tests available for finding those women who will have a preterm birth when there is just one baby, but unfortunately none of these has been shown to be of benefit in twin pregnancy. Also, to date, no treatment has been shown to be effective in stopping a twin pregnancy from delivering early. Most of the research on twin pregnancy has been done in the middle of the pregnancy, at 20 weeks, but it is possible that starting earlier in the pregnancy has a greater chance of finding those women who will deliver very early.

There has been interest for many years in how microscopic organisms (such as bacteria and yeasts) in the vagina (microbiota) and proteins released from the cervix (fibronectin) may be linked to preterm birth in pregnancies with one baby but little has been done in twin pregnancy

Doctors at Liverpool Women’s Hospital suggest that looking for evidence of how the microbiota and fibronectin are related to the number of weeks women with twins are when they go into labour would be useful and may suggest new targets for future treatments to prevent preterm birth in twins.

They will also compare the results of this study in twins against previously collected samples from women with one baby who were at high and low risk of preterm birth, to see if there are differences in how twins affect a pregnancy.

This study is being carried out by Dr Andrew Sharp at Liverpool Women’s Hospital, and was funded by the Twins Trust and BMFMS research bursaries.