Establishment of vaginal microbiota composition in early pregnancy and its association with subsequent preterm prelabor rupture of the fetal membranes
Establishment of vaginal microbiota composition in early pregnancy and its association with subsequent preterm prelabor rupture of the fetal membranes
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DOI：
10.1016/j.trsl.2018.12.005
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发表时间：
2019-05-01
影响因子：
7.8
通讯作者：
Macintyre, David A.
中科院分区：
文献类型：
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作者：
Brown, Richard G.;Al-Memar, Maya;Macintyre, David A.
阴道细菌群落组成影响妊娠结局。早产前胎膜破裂（PPROM）发生在所有自发性早产的30%之前，与破裂前阴道细菌的高度多样性有关。在PPROM之前建立阴道细菌多样性的点是未知的。在这项研究中，我们使用metataxonomics纵向特征的阴道细菌组成，早在6周妊娠的妇女在高（n = 38）和低（n = 22）的早产风险，随后经历PPROM和妇女在足月分娩无并发症（n = 36）。还原乳杆菌属在PPROM前，分别有20%和26%的早产低风险和高风险妇女中观察到了丰富和高度多样性，但在足月分娩的妇女中只有3%。PPROM与妊娠期间细菌群落结构的不稳定性以及主要发生在妊娠中期的向更高多样性的转变有关。其特征在于潜在致病性物种的相对丰度增加，包括普雷沃氏菌属、嗜消化菌属、链球菌属和小杆菌属。本研究鉴定了还原乳杆菌属。丰富和增加的阴道细菌多样性作为PPROM的早期风险因素，并强调需要进行干预性研究，旨在评估修改阴道细菌组成对预防早产的影响。
Vaginal bacterial community composition influences pregnancy outcome. Preterm prelabor rupture of the fetal membranes (PPROM), which precedes 30% of all spontaneous preterm births, is associated with high vaginal bacterial diversity prior to rupture. The point at which vaginal bacterial diversity is established before PPROM is unknown. In this study, we use metataxonomics to longitudinally characterize the vaginal bacterial composition from as early as 6 weeks of gestation in women at high (n = 38) and low (n = 22) risk of preterm birth who subsequently experience PPROM and in women delivering at term without complications (n = 36). Reduced Lactobacillus spp. abundance and high diversity was observed prior to PPROM in 20% and 26% of women at low and high risk of preterm births respectively, but in only 3% of women who delivered at term. PPROM was associated with instability of bacterial community structure during pregnancy and a shift toward higher diversity predominately occurring during the second trimester. This was characterized by increased relative abundance of potentially pathogenic species including Prevotella, Peptoniphilus, Streptococcus, and Dialister. This study identifies reduced Lactobacillus spp. abundance and increasing vaginal bacterial diversity as an early risk factor for PPROM and highlights the need for interventional studies designed to assess the impact of modifying vaginal bacterial composition for the prevention of preterm birth.