The genitourinary microbiome plays a crucial role in the establishment and maintenance of urinary and reproductive health in women throughout their lives. Particularly during the reproductive stage, resident microorganisms contribute to implantation and protect against perinatal complications, including preterm birth, stillbirth, and low birth weight, while also serving as the first line of defense against pathogens that can cause infections, such as urinary tract infections and bacterial vaginosis. This review aimed to elucidate the relationship between a healthy microbiome environment and women’s overall health. We examine the variability and dynamics of the microbiome during different developmental stages, ranging from the prepubertal to the postmenopausal stage. Furthermore, we explore the significance of a healthy microbiota in successful implantation and pregnancy development and investigate potential differences between women experiencing infertility. In addition, we analyze the local and systemic inflammatory responses associated with the establishment of a dysbiotic state and compare it to a condition where a healthy microbiome was established. Lastly, we present the most recent evidence regarding preventive measures, such as dietary interventions and the use of probiotics to promote and maintain a healthy microbiome, thereby ensuring comprehensive women’s health. By highlighting the importance of the genitourinary microbiome in reproductive health, this review aimed to enhance this microbiome’s visibility and significance in the field.

Adolescent pregnancy is a significant public health concern, with maternal and fetal risks compounded by pregnancy-related anatomical, hormonal, and urinary changes that predispose to urinary tract infections (UTIs). Alterations in the urinary microbiome may further influence infection susceptibility, yet little is known about its role during adolescent pregnancy. This study analyzed the urinary microbiome of adolescent pregnant patients and its association with UTI and recurrent UTI (rUTI) across gestation. Healthy adolescents were enrolled in the first trimester and followed through subsequent trimesters, with urine samples collected at each visit for microbiological diagnosis. Patients were classified as healthy (34 samples), single UTI (22 samples), or rUTI (31 samples), and oxford-nanopore 16S rRNA sequencing was used to assess taxonomic composition, microbial diversity, and operational taxonomic units. Distinct trimester-specific patterns were observed, with Lactobacillus iners progressively increasing and L. kitasatonis emerging as a dominant taxon during adolescent pregnancy. Interestingly, rUTI cases showed persistent E. coli, reduced L. kitasatonis and L. ultunensis in the second trimester, and the appearance of Fannyhessea vaginae (Atopobium vaginae) in the third. These findings suggest a potential microbial signature of rUTI in adolescent pregnancy, underscoring the need for personalized preventive strategies and the establishment of microbiome-based clinical cutoffs.

Background. Gestational weight gain (GWG) constitutes an essential aspect of the gestational process. Due to factors such as pregestational body mass index (BMI), nutritional intake, level of physical activity, and psychological aspects, the recommended GWG may not be achieved, leading to adverse neonatal outcomes. Adolescents, due to their physiological and mental developmental stage, are at a higher risk of inappropriate GWG. Our aim is to highlight the importance of GWG in our population and to determine the correlation with perinatal outcomes. Methods. Pregnant adolescents who attended a tertiary care institution for prenatal care were included; maternal data such as preBMI and GWG were used to determine maternal and neonatal outcomes using the chi-square test and OR determination. Results. A total of 202 adolescent pregnant patients were included, comprising those with inadequate GWG (n = 70), adequate GWG (n = 85), and excessive GWG (n = 47). A statistically significant association was found between low BMI and inadequate GWG. Patients with inadequate GWG demonstrated a correlation with IUGR and low birth weight, while patients with excessive GWG gave birth to macrosomic neonates. Conclusion. We concluded that previous habits play a significant role in determining weight gain throughout pregnancy. GWG has a direct impact on neonatal growth and development.

The aim of this study was to characterize the vaginal microbiome during early pregnancy according to maternal metabolic status, including prepregnancy body mass index (BMI) and gestational weight gain (GWG), and to explore its relationship with subsequent birth outcomes. A prospective observational cohort study was conducted with sixty-nine pregnant women recruited during the first trimester of pregnancy. Vaginal samples collected between 11 and 13.6 weeks of gestation were analyzed using long-read 16S-rRNA gene sequencing (Oxford Nanopore Technologies). Microbial composition, alpha diversity (richness, Shannon diversity, and evenness), and community structure were evaluated according to prepregnancy BMI, GWG, and birth outcomes. Vaginal microbial communities were predominantly composed of Lactobacillus species across all groups; however, distinct ecological configurations were observed according to maternal metabolic status. Women with normal prepregnancy BMI exhibited a greater representation of Lactobacillus crispatus, whereas overweight, obesity, and excessive GWG were characterized by a predominance of Lactobacillus iners. Maternal obesity was associated with reduced richness and diversity, a trend toward lower community evenness, and enrichment of anaerobic taxa. Women with adverse birth outcomes, particularly preterm birth, exhibited greater community heterogeneity and a higher contribution of non-Lactobacillus anaerobes. Overall, maternal metabolic status was associated with distinct vaginal microbiome configurations during early pregnancy. These findings suggest subtle ecological differences in the predominance of Lactobacillus species, community composition, and microbial diversity that may be relevant to subsequent obstetric outcomes.