Changes in the Vaginal Microbiome During Pregnancy and the Postpartum Period in South African Women: a Longitudinal Study.
Changes in the Vaginal Microbiome During Pregnancy and the Postpartum Period in South African Women: a Longitudinal Study.
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DOI：
10.1007/s43032-023-01351-4
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发表时间：
2024-01
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撒哈拉以南非洲的孕妇孕产妇发病率很高。人们感兴趣的是阴道微生物组对孕产妇健康的影响，包括对艾滋病毒和性传播感染的影响。我们对南非18岁以上感染或未感染艾滋病毒的妇女的阴道微生物群进行了纵向队列研究，在怀孕期间和产后分别进行了两次访问。在每次访问中，我们都进行了艾滋病毒检测和自行收集的阴道拭子，以便在护理点进行性传播感染检测和微生物群测序。我们对微生物群落进行了分类，并评估了怀孕期间的变化及其与HIV状态和STI诊断的关系。在242名女性（平均年龄29岁，44%感染艾滋病毒，33%诊断为性传播感染）中，我们确定了四种主要的社区状态类型（CSTs）：两种以乳酸菌为主的CSTs（分别以crispatus乳杆菌和iners乳杆菌为主）和两种多样的非乳酸菌为主的CSTs（一种以阴道加德纳菌为主，另一种以多种兼性厌氧菌为主）。从第一次产前检查到妊娠晚期（妊娠24-36周），60%的加德纳菌优势型CST妇女转变为乳酸菌优势型CST。从妊娠晚期到产后（平均分娩后17天），80%乳酸菌为主的CST转变为非乳酸菌为主的CST，兼性厌氧菌为主的CST占很大比例。微生物组成因性传播感染诊断而异（PERMANOVA R2 = 0.002, p = 0.004），被诊断为性传播感染的女性更有可能被归类为L. ers显性CSTs或加德纳菌显性CSTs。总的来说，我们发现在怀孕期间乳酸菌占优势，在产后出现了一个独特的、高度多样化的厌氧菌占优势的微生物群。在线版本包含补充材料，下载地址：10.1007/s43032-023-01351-4。
Pregnant women in sub-Saharan Africa have high rates of maternal morbidity. There is interest in the impact of the vaginal microbiome on maternal health, including HIV and sexually transmitted infection (STI) acquisition. We characterized the vaginal microbiota of South African women ≥ 18 years with and without HIV in a longitudinal cohort over two visits during pregnancy and one visit postpartum. At each visit, we obtained HIV testing and self-collected vaginal swabs for point-of-care testing for STIs and microbiota sequencing. We categorized microbial communities and evaluated changes over pregnancy and associations with HIV status and STI diagnosis. Across 242 women (mean age 29, 44% living with HIV, 33% diagnosed with STIs), we identified four main community state types (CSTs): two lactobacillus-dominant CSTs (dominated by Lactobacillus crispatus and Lactobacillus iners respectively) and two diverse, non-lactobacillus-dominant CSTs (one dominated by Gardnerella vaginalis and one by diverse facultative anaerobes). From the first antenatal visit to the third trimester (24–36 weeks gestation), 60% of women in the Gardnerella-dominant CST shifted to lactobacillus-dominant CSTs. From the third trimester to postpartum (mean 17 days post-delivery), 80% of women in lactobacillus-dominant CSTs shifted to non-lactobacillus-dominant CSTs with a large proportion in the facultative anaerobe-dominant CST. Microbial composition differed by STI diagnosis (PERMANOVA R2 = 0.002, p = 0.004), and women diagnosed with an STI were more likely to be categorized as L. iners-dominant or Gardnerella-dominant CSTs. Overall, we found a shift toward lactobacillus dominance during pregnancy and the emergence of a distinct, highly diverse anaerobe-dominant microbiota profile in the postpartum period. The online version contains supplementary material available at 10.1007/s43032-023-01351-4.
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影响因子：
4.6
作者：
通讯作者：
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影响因子：
16.6
作者：
Balle C;Konstantinus IN;Jaumdally SZ;Havyarimana E;Lennard K;Esra R;Barnabas SL;Happel AU;Moodie Z;Gill K;Pidwell T;Karaoz U;Brodie E;Maseko V;Gamieldien H;Bosinger SE;Myer L;Bekker LG;Passmore JS;Jaspan HB
通讯作者：
Jaspan HB
影响因子：
15.5
作者：
Bender JM;Li F;Adisetiyo H;Lee D;Zabih S;Hung L;Wilkinson TA;Pannaraj PS;She RC;Bard JD;Tobin NH;Aldrovandi GM
通讯作者：
Aldrovandi GM
DOI：
10.1073/pnas.1502875112
发表时间：
2015-09-01
影响因子：
11.1
作者：
DiGiulio, Daniel B.;Callahan, Benjamin J.;Relman, David A.
通讯作者：
Relman, David A.
影响因子：
15.5
作者：
Davis, Nicole M;Proctor, Diana M;Callahan, Benjamin J
通讯作者：
Callahan, Benjamin J