Goodfellow L, Verwijs MC, Care A, et al. - Researchers conducted a nested case–control study investigating if vaginal microbiome (VMB) composition correlates with recurrent early spontaneous preterm birth (sPTB)/preterm prelabour rupture of membranes (PPROM). Participants were high-risk women with previous sPTB/PPROM < 34 ⁺⁰ weeks’ gestation who had a recurrence (n = 22) or delivered at ≥ 37 ⁺⁰ weeks without PPROM (n = 87). Among the 109 high-risk women, anaerobic vaginal dysbiosis was detected in 28, with the remainder dominated by lactobacilli (Lactobacillus iners 36/109, Lactobacillus crispatus 23/109, or other 22/109). Outcomes suggest correlation of vaginal bacterial load with early sPTB/PPROM recurrence. Domination by lactobacilli other than L. iners may avert development of high bacterial loads in women.