Abstract
Preterm pre-labor rupture of membranes (PPROM) increases maternal and neonatal sepsis risk, yet its association with maternal microbial translocation and systemic inflammation remains unclear. We investigated whether PPROM is linked to microbial DNA in maternal blood (MB) and inflammatory responses around delivery. In 66 PPROM patients (median GA: 32 weeks), MB was collected pre-delivery and within 1 h postpartum. Fetal membranes (FM) and placental tissues were sampled immediately after delivery. Bacterial load and diversity were analyzed via 16 S rDNA qPCR and sequencing. Maternal cytokines were quantified by multiplex immunoassay, and fetal inflammatory exposure (Triple I) assessed using histological chorioamnionitis (HCA), cord blood haptoglobin, and IL-6. Bacterial DNA was detected in maternal blood (MB) pre- and post-delivery, with a significant postpartum decline (p = 0.004). FM carried higher bacterial load and biodiversity than placenta (p < 0.001), dominated by Mycoplasma spp. Maternal IL-6 and IL-10 levels rose postpartum (p < 0.05), particularly in cases with fetal inflammatory exposure. Limited overlap was found between MB and tissue microbial taxa. In conclusion, bacterial DNA is detectable in maternal circulation in patients with PPROM before birth but rapidly clears postpartum alongside a robust cytokine surge, suggesting efficient clearance and dynamic inflammatory changes.
Data availability
The anonymized dataset generated and analyzed during the current study is available from the Zenodo repository at: (https:/doi.org/10.5281/zenodo.16898408) . Patient level clinical data is not openly available due to privacy concerns but is available from the corresponding author upon reasonable request. The raw and processed amplicon sequencing data are available in the Gene Expression Omnibus (GEO) database at the accession number GSE306804.
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Funding
The study was supported by research funds from the Division of Maternal Fetal Medicine at The Ohio State University College of Medicine and from The Center for Perinatal Research at The Research Institute at Nationwide Children’s Hospital, Columbus, OH. Additionally, participation of Anthony J. Moussa was made possible through funds provided by Eunice Kennedy Shriver National Institute of Health and Human Development (NICHD) R25 HD086885 Futures Matter: Transformative Transdisciplinary Summer Research Program (to I.A.B.). The funding sources had no involvement in the study design, collection, analysis and interpretation of data, writing of the report, or decision to submit the paper for publication.
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Conceptualization: CSB, IAB; Patient enrollment: SW, KMR, KB, CSB; Laboratory methods and analyses: GZ, LS, SDW, MG, SH, AM, SG, HJ, WEA, IAB; Supervision: IAB, CSB; Writing—original draft: CSB, IAB; Writing—review & editing: AM, KMR, LS, SDW, MG, SG, SH, HJ, GZ, KB, WEA, IAB, CSB.
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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national guidelines on human experimentation (U.S. Department of Health and Human Services Policy for Protection of Human Subjects) and with the Helsinki Declaration of 1975, as revised in 2008, and has been approved by the Institutional Review Boards at The Ohio State University Wexner Medical Center and The Abigail Wexner Research Institute at Nationwide Children’s Hospital.
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Buhimschi, C.S., Zhao, G., Rood, K.M. et al. Rapid clearance of bacteria from maternal bloodstream after delivery in pregnancies complicated by preterm pre-labor rupture of the membranes. Sci Rep (2026). https://doi.org/10.1038/s41598-026-37231-5
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DOI: https://doi.org/10.1038/s41598-026-37231-5
