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首页> 外文期刊>BJOG: an international journal of obstetrics and gynaecology >The association between vaginal bacterial composition and miscarriage: a nested case–control study
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The association between vaginal bacterial composition and miscarriage: a nested case–control study

机译：阴道细菌组成和流产之间的关联：嵌套病例对照研究

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Objective To characterise vaginal bacterial composition in early pregnancy and investigate its relationship with first and second trimester miscarriages. Design Nested case–control study. Setting Queen Charlotte’s and Chelsea Hospital, Imperial College Healthcare NHS Trust, London. Population 161 pregnancies: 64 resulting in first trimester miscarriage, 14 in second trimester miscarriage and 83 term pregnancies. Methods Prospective profiling and comparison of vaginal bacteria composition using 16S rRNA gene‐based metataxonomics from 5?weeks’ gestation in pregnancies ending in miscarriage or uncomplicated term deliveries matched for age, gestation and body mass index. Main outcome measures Relative vaginal bacteria abundance, diversity and richness. Pregnancy outcomes defined as first or second trimester miscarriage, or uncomplicated term delivery. Results First trimester miscarriage associated with reduced prevalence of Lactobacillus spp.‐dominated vaginal microbiota classified using hierarchical clustering analysis (65.6 versus 87.7%; P? =?0.005), higher alpha diversity (mean Inverse Simpson Index 2.5 [95% confidence interval 1.8–3.0] versus 1.5 [1.3–1.7], P? =?0.003) and higher richness 25.1 (18.5–31.7) versus 16.7 (13.4–20), P? =?0.017), compared with viable pregnancies. This was independent of vaginal bleeding and observable before first trimester miscarriage diagnosis ( P? =?0.015). Incomplete/complete miscarriage associated with higher proportions of Lactobacillus spp.‐depleted communities compared with missed miscarriage. Early pregnancy vaginal bacterial stability was similar between miscarriage and term pregnancies. Conclusions These findings associate the bacterial component of vaginal microbiota with first trimester miscarriage and indicate suboptimal community composition is established in early pregnancy. While further studies are required to elucidate the mechanism, vaginal bacterial composition may represent a modifiable risk factor for first trimester miscarriage. Tweetable abstract Vaginal bacterial composition in first trimester miscarriage is associated with reduced Lactobacillus spp. abundance and is independent of vaginal bleeding.
机译：目的在妊娠早期表征阴道细菌组合物，并与第一三个月流产的关系。设计嵌套案例控制研究。设置女王夏洛特和切尔西医院，帝国学院医疗保健NHS Trust，伦敦。人口161次怀孕：64导致妊娠期流产，14名三个月流产和83例怀孕。方法预期剖析和阴道细菌组合物的比较使用16S rRNA基因的甲状腺组合物从5？周的妊娠期妊娠结束的妊娠或短暂的术语交付，妊娠和体重指数匹配。主要结果测量相对阴道细菌丰富，多样性和丰富性。怀孕结果定义为第一个或第二个三个月流产或简单的术语交付。结果使用等级聚类分析分类的乳酸杆菌SPP患病率降低的前妊娠流产相关性3.0]与1.5 [1.3-1.7]，p？= 0.003）和较高的丰富性25.1（18.5-31.7）与16.7（13.4-20），P？ = 0.017），与活妊娠相比。这与阴道出血和观察到妊娠妊娠诊断（P？= 0.015）无关。与错过的流产相比，与乳酸杆菌菌株的更高比例相关的不完全/完全流产。妊娠早期阴道细菌稳定性在流产和术语术语之间相似。结论这些研究结果将阴道微生物群的细菌成分与前三个月的流产相关，并表明在妊娠早期建立次优群落组成。虽然需要进一步的研究来阐明机制，但阴道细菌组合物可以代表前妊娠流产的可改性危险因素。第一次三孕脉流产的Twelable抽象的阴道细菌组合物与降低的乳杆菌SPP相关。丰富，独立于阴道出血。

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