Preterm birth remains one of the leading causes of neonatal morbidity and mortality worldwide. Growing evidence indicates that metabolic disorders, particularly insulin resistance, together with dysbiosis of the gut and vaginal microbiota, contribute to the development of chronic low-grade inflammation and placental dysfunction, thereby increasing the risk of preterm delivery. The aim of this study is to evaluate the contribution of metabolic alterations associated with microbiota imbalance to the development of preterm birth and to develop criteria for early risk prediction based on an integrated assessment of clinical, biochemical, and microbiological indicators. The study is planned to include 120 pregnant women from the Bukhara region, divided into a study group with insulin resistance and a control group with physiologically normal pregnancy. Clinical and anamnestic evaluation, biochemical analysis, microbiological assessment of gut and vaginal microbiota, ultrasound examination, Doppler velocimetry, and statistical modeling methods will be applied. The expected outcome of the study is the development of an early predictive model for preterm birth that enables timely identification of high-risk pregnant women. Implementation of this model may facilitate personalized preventive strategies, including metabolic correction and microbiota-targeted interventions, thereby improving pregnancy outcomes and reducing the incidence of preterm birth in clinical practice.