Study on vaginal microbiota in patients with missed abortion
SHI Suya BAI Huihui DU Mengyao CHENG Dongmei FAN Linyuan CHEN Suwen LIU Zhaohui
Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University Maternal and Child Health Care Hospital, Beijing 100026, China
Abstract:Objective To analyze the vaginal microbiota of patients with missed abortion. Methods Patients attending Beijing Obstetrics and Gynecology Hospital, Capital Medical University from September 2020 to June 2021 were selected, 30 patients with missed abortion were included in the experimental group, and 30 normal early pregnancy who planned in the control group. Furthermore, the patients with missed abortion were further divided into 16 patients with normal chromosome group, six patients with abnormal chromosome group, and eight patients with unknown chromosome group according to the results of fetal villus chromosome examination. The questionnaire was filled in and the microecology detection of vaginal secretions was performed. The baseline data and vaginal microecology indexes of the four groups were compared by single factor. Meanwhile, 16S rRNA high-throughput sequencing technology was used to analyze the differences of vaginal microflora between the four groups. Results The comparison of baseline data and microecological indicators of the four groups showed that there were statistically significant differences in whether the four groups had a history of pelvic inflammatory disease, bacterial diversity, and dominant bacteria (P<0.05), among which the proportion of patients with a history of pelvic inflammatory disease and the age of first sexual life in the chromosome abnormality group were higher than those in the control group (P<0.05). The proportion of patients with previous abortion history was lower than that of control group (P<0.05). The results of OTU cluster analysis showed that, compared with the missed abortion group, the number of OTUs in the control group was more, and the bacteria community was more abundant. The results of species classification analysis showed that, compared with the control group, normal chromosome group had imbalance of different lactobacillus strains (increased Lactobacillus inners, decreased Lactobacillus unclassified), and the relative abundance of other bacteria except Lactobacillus (Gardnerella, Prevotella, Escherichia-Shigella, etc.) increased. There was no significant difference in the abundance and proportion of Lactobacillus strains in the abnormal chromosome group. The results of Alpha diversity analysis showed that there were significant differences in the flora abundance among the four groups (P<0.05). The flora abundance of the normal chromosome group was lower than that of the control group (P<0.05), there was no difference in the flora abundance between the abnormal chromosome group and the control group (P>0.05). The results of β-diversity analysis and line discriminant analysis effect size analysis showed that there was not significant difference in vaginal flora among the four groups (P>0.05). Conclusion The imbalance of vaginal microflora in patients with missed abortion may be related to the decreased relative abundance of Lactobacillus and / or the imbalance in the proportion of different Lactobacillus strains and the increased relative abundance of other bacteria except Lactobacillus (Gardnerella, Prevotella, Escherichia-Shigella, etc.) in the vaginal microflora, but its direct etiology and mechanism need further study.
石素雅 白会会 杜梦瑶 程冬梅 范琳媛 陈素文 刘朝晖. 稽留流产患者阴道菌群状况研究[J]. 中国医药导报, 2023, 20(26): 4-10.
SHI Suya BAI Huihui DU Mengyao CHENG Dongmei FAN Linyuan CHEN Suwen LIU Zhaohui. Study on vaginal microbiota in patients with missed abortion. 中国医药导报, 2023, 20(26): 4-10.
[1] 谢幸,孔北华,段涛,等.妇产科学[M].9版.北京:人民卫生出版社,2018:84.
[2] 张伟.不明原因习惯性流产患者血清炎性因子与血液流变学指标变化的临床意义[J].中国医药,2015,10(8):3.
[3] Witkin SS,Moron AF,Linhares IM,et al. The vaginal microbiome in pregnant women:knowledge gaps in relation to clinical relevance [J]. BJOG,2021,128(1):8-11.
[4] 佟玉,王薇.妊娠期阴道微生态变化与妊娠结局的研究进展[J].中国妇幼保健,2019,34(9):2173-2176.
[5] 李婷,黎欢,李金灵,等.阴道微生态研究进展概述[J].中国妇幼保健,2022,37(3):574-576.
[6] 王慧慧,李焕荣,马晓彤,等.阴道微生态的研究进展[J].中国微生态学杂志,2020,32(4):469-471.
[7] France MT,Ma B,Gajer P,et al. VALENCIA:a nearest centroid classification method for vaginal microbial communities based on composition [J]. Microbiome,2020,8(1):166.
[8] Solomon M,Henkel R. Semen culture and the assessment of genitourinary tract infections [J]. Indian J Urol,2017,33(3):188-193.
[9] Moreno I,Garcia-Grau I,Bau D,et al. The first glimpse of the endometrial microbiota in early pregnancy [J]. Am J Obstet Gynecol,2020,222(4):296-305.
[10] Wang S,Dou Y,Yang H,et al. Alteration of glucocorticoid receptors and exacerbation of inflammation during lytic cytomegalovirus infection in THP-1 cells [J]. FEBS Open Bio, 2017,7(12):1924-1931.
[11] 金影.生殖道感染及全身微炎症状态与复发性流产的研究进展[J].中国医刊,2021,56(6):604-608.
[12] 任燕.不同妊娠阶段女性阴道微生态变化状况分析[J].中国妇幼保健,2018,33(15):3432-3434.
[13] 李丹,王世军.不同年龄段女性妊娠早期阴道微生态状况分析[J].中国医刊,2020,55(9):1005-1007.
[14] 马小星.妊娠期阴道微生态变化对早产的预测价值[J].检验医学与临床,2021,18(6):823-826.
[15] 陶址,廖秦平.妊娠期阴道微生态变化[J].中国实用妇科与产科杂志,2021,37(10):992-994.
[16] 黄振宇,张蕾,尚梦远,等.早孕期和晚孕期阴道微生态菌群的研究[J].中国妇产科临床杂志,2021,22(3):3.
[17] Li D,Chi XZ,Zhang L,et al. Vaginal microbiome analysis of healthy women during different periods of gestation [J]. Biosci Rep,2020,40(7):BSR20201766.
[18] Kumar S,Kumari N,Talukdar D,et al. The Vaginal Microbial Signatures of Preterm Birth Delivery in Indian Women [J]. Front Cell Infect Microbiol,2021,11:622474.
[19] Garcia-Grau I,Perez-Villaroya D,Bau D,et al. Taxonomical and functional assessment of the endometrial microbiota in a context of recurrent reproductive failure:a case report [J]. Pathogens,2019,8(4):205.
[20] Moreno I,Garcia-Grau I,Bau D,et al. The first glimpse of the endometrial microbiota in early pregnancy [J]. Am J Obstet Gynecol,2020,222(4):296-305.
[21] Fettweis JM,Serrano MG,Brooks JP,et al. The vaginal microbiome and preterm birth [J]. Nat Med,2019,25(6):1012- 1021.
[22] Elovitz MA,Gajer P,Riis V,et al. Cervicovaginal microbiota and local immune response modulate the risk of spontaneous preterm delivery [J]. Nat Commun,2019,10(1):1305.
[23] Ve?觢■i■ík P,Musilová K,Stráník J,et al. Lactobacillus cris- patus dominant vaginal microbita in pregnancy [J]. Ceska Gy- nekol,2020,85(1):67-70.
[24] Mls J,Stráník J,Kacerovsky M. Lactobacillus iners-dominated vaginal microbiota in pregnancy [J]. Ceska Gynekol,2019,84(6):463-467.
[25] Chen S,Xue X,Zhang Y,et al. Vaginal Atopobium is Associated with Spontaneous Abortion in the First Trimester:a Prospective Cohort Study in China [J]. Microbiol Spectr,2022,10(2):e02039-21.
[26] Sun D,Zhao X,Pan Q,et al. The association between vaginal microbiota disorders and early missed abortion:A pro- spective study [J]. Acta Obstet Gynecol Scand,2022,101 (9):960-971.
[27] Donders GGG,Ruban K,Bellen G,et al. Mycoplasma/Ureaplasma infection in pregnancy:to screen or not to screen [J]. J Perinat Med,2017,45(5):505-515.