Impact of Sociodemographic, Clinical, and Genetic Factors and Fusobacterium nucleatum on Premature Birth Outcomes in Women from Kazakhstan: A Case-Control Study.

BACKGROUND: Premature birth (delivery before 37 weeks of gestation) is a leading cause of neonatal morbidity and mortality worldwide. Specific genetic polymorphisms were associated with immune and inflammatory pathways that might contribute to its pathogenesis. This study investigated the associations between preterm birth and sociodemographic indicators, clinical outcomes, genetic polymorphisms, and microbial factors in Kazakh women. METHODS: This case-control study was conducted from September 2022 to September 2023. It enrolled women with preterm and full-term births in Kyzylorda, Kazakhstan. Data included sociodemographic, clinical variables, genotyping (TLR2 rs4986790 and MBL2 rs11003125), and microbial data. The quantification of Fusobacterium nucleatum (F. nucleatum) in saliva samples was performed using TaqMan real-time PCR. Statistical analysis was conducted using SPSS software (version 26), employing independent sample t tests, Chi square tests, Mann-Whitney U tests, and logistic regression. The level of significance was set at P<0.05. RESULTS: Sociodemographic analysis showed no significant differences between the studied groups, except for a higher prevalence of previous preterm birth in the case group. Clinical comparisons revealed significantly lower gestational age at delivery, reduced newborn weight and height, decreased placental weight and dimensions, lower hemoglobin levels, and erythrocyte counts in preterm cases. Genetic analysis demonstrated that all women with preterm labor carried the homozygous AA genotype of TLR299 rs4986790, while the GG genotype and the G allele of the MBL2 rs11003125 gene were predominant in this group. Furthermore, the quantitative analysis identified significantly higher F. nucleatum levels associated with premature birth, highlighting a potential microbial role in its pathogenesis. CONCLUSION: These findings suggested that a history of preterm birth, specific genetic polymorphisms, and microbial factors collectively were associated with an increased risk of preterm birth.