目的:本研究旨在确定阴道菌群与绒毛膜羊膜炎之间的关联及其预测价值。
方法:前瞻性招募30名妊娠晚期孕妇。根据临床表现和胎盘病理将参与者分为三组:临床绒毛膜羊膜炎组(IP组),无症状的组织学绒毛膜羊膜炎组(CP组),健康对照组(CN组)。从每个参与者收集基本数据和病史。在递送前收集阴道样品并使用微生物多样性测序进行分析。
结果:在年龄上没有观察到显著差异,身体质量指数,各组间教育情况(P>0.05)。然而,IP组低出生体重率较高(60%vs20%vs0%,P=0.008)和呼吸窘迫综合征(50%vs20%vs0%,P=0.003)与CP和CN组比较。香农指数[2.09(1.16-3.86)vs0.84(0.19-1.11)vs0.44(0.25-0.85),P=0.009]和辛普森指数[0.70(0.41-0.81)vs0.26(0.04-0.39)vs0.11(0.05-0.29),IP组P=0.010]高于CN和CP组。β多样性分析表明,三组间微生物群落结构不同,14.1%的变异与群体差异相关(P=0.002)。在属一级,随机森林模型揭示了乳酸菌,Dialister,普雷沃氏菌,小杆菌,缺氧球菌的Gini指数均高于1。Further,线性判别分析(LDA)表明,IP组crispatus的丰度低于CN组(LDA>4.0,平均相对丰度9.19%vs54.40%,P=0.031)。logistic回归分析显示,crispatus的丰度降低与临床绒毛膜羊膜炎的风险增加有关。
结论:crispatus的减少和特定厌氧组的增加趋势与绒毛膜羊膜炎的发病有关,表明它们在绒毛膜羊膜炎鉴定中的潜在价值。阴道微生物群可以作为预测未来疾病和定制监测工作的有用生物标志物。此外,它可能是制定预防和治疗策略的可行目标。
OBJECTIVE: This study aimed to determine the association between vaginal microbiota and chorioamnionitis and its predictive value.
METHODS: Thirty pregnant women in their third trimester were prospectively recruited. The participants were categorized into three groups based on their clinical manifestations and placental pathology: the clinical chorioamnionitis group (IP group), the asymptomatic histological chorioamnionitis group (CP group), and the healthy control group (CN group). Basic data and medical history were collected from each participant. Vaginal samples were collected before delivery and analyzed using microbial diversity sequencing.
RESULTS: No significant differences were observed in age, body mass index, and education among the groups (P > 0.05). However, the IP group exhibited higher rates of low birth weight (60 % vs 20 % vs 0 %, P = 0.008) and respiratory distress syndrome (50 % vs 20 % vs 0 %, P = 0.003) compared with the CP and CN groups. The Shannon index [2.09 (1.16-3.86) vs 0.84 (0.19-1.11) vs 0.44 (0.25-0.85), P = 0.009] and Simpson index [0.70 (0.41-0.81) vs 0.26 (0.04-0.39) vs 0.11 (0.05-0.29), P = 0.010] in the IP group were higher than those in the CN and CP groups. β diversity analysis indicated that the microbial community structure differed among the three groups, with a 14.1 % variation associated with group differences (P = 0.002). At the genus level, the random forest model revealed that Lactobacillus, Dialister, Prevotella, Ligilactobacillus, and Anaerococcus had Gini indexes higher than 1. Further, linear discriminant analysis (LDA) demonstrated that the abundance of Lactobacillus crispatus in the IP group was lower than in the CN group (LDA >4.0, mean relative abundance 9.19 % vs 54.40 %, P = 0.031). The logistic regression analysis indicated that a decreased abundance of L. crispatus was associated with an increased risk of clinical chorioamnionitis.
CONCLUSIONS: The reduction of L. crispatus and increasing trend of specific anaerobic groups are associated with the onset of chorioamnionitis, suggesting their potential value in chorioamnionitis identification. The vaginal microbiota could serve as a useful biomarker for predicting future disease and tailoring surveillance efforts. Additionally, it may present a viable target for developing prevention and therapeutic strategies.