Dunlop Anne L, Jordan Sheila L, Ferranti Erin P, Hill Cherie C, Patel Shiven, Hao Li, Corwin Elizabeth J, Tangpricha Vin
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA.
Department of Family & Preventive Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA.
Infect Dis Obstet Gynecol. 2019 Jan 1;2019:9426795. doi: 10.1155/2019/9426795. eCollection 2019.
This study sought to investigate associations between serum total and free 25(OH)D and bacterial vaginosis (BV) in early and later pregnancy among US black women to provide insight into the most clinically relevant measure of vitamin D status among pregnant black women with respect to risk for BV as well as insights into critical time points for measuring and/or addressing vitamin D status in pregnancy.
Data and biospecimens were derived from a subsample (N = 137) of women from the Emory University African American Vaginal, Oral, and Gut Microbiome in Pregnancy Cohort, for whom data related to vitamin D status (serum assays for total and free 25(OH)D) and Nugent score of Gram stained vaginal specimens in early (8-14 weeks) and later (24-30 weeks) were available. We compared total and free 25(OH)D concentrations for women according to Nugent score category (normal flora, intermediate flora, and BV) and assessed the odds of BV according to measures of vitamin D status.
Thirty-seven (27%) women had adequate vitamin D status at baseline, whereas 70 (51%) had insufficient vitamin D and 30 (22%) were vitamin D deficient; there were not significant differences in the proportion of women with adequate, insufficient, or deficient vitamin D according to Nugent score category. However, the odds of BV later in pregnancy were significantly higher for women who experienced a smaller rise in total 25(OH)D and free 25(OH)D from 8-14 through 24-30 weeks gestation.
The change in measures of vitamin D status from early to later pregnancy is associated with the occurrence of BV in pregnancy. Further research is needed to examine the association between the change in vitamin D status over pregnancy and the occurrence of BV and other measures of vaginal microbial composition as well as to identify factors that influence change in vitamin D status over pregnancy.
本研究旨在调查美国黑人女性在妊娠早期和晚期血清总25(OH)D和游离25(OH)D与细菌性阴道病（BV）之间的关联，以便深入了解妊娠黑人女性中与BV风险相关的最具临床相关性的维生素D状态指标，并了解在孕期测量和/或调整维生素D状态的关键时间点。
数据和生物样本来自埃默里大学妊娠队列中非洲裔美国女性阴道、口腔和肠道微生物组研究的一个子样本（N = 137），这些女性有妊娠早期（8 - 14周）和晚期（24 - 30周）的维生素D状态（血清总25(OH)D和游离25(OH)D检测）以及革兰氏染色阴道标本的 Nugent评分数据。我们根据 Nugent评分类别（正常菌群、中间菌群和BV）比较了女性的总25(OH)D和游离25(OH)D浓度，并根据维生素D状态指标评估了BV的几率。
37名（27%）女性在基线时维生素D状态充足，而70名（51%）维生素D不足，30名（22%）维生素D缺乏；根据 Nugent评分类别，维生素D充足、不足或缺乏的女性比例无显著差异。然而，从妊娠8 - 14周到24 - 30周期间，总25(OH)D和游离25(OH)D升高幅度较小的女性，在妊娠后期患BV的几率显著更高。
从妊娠早期到晚期维生素D状态指标的变化与孕期BV的发生有关。需要进一步研究来检查孕期维生素D状态变化与BV发生以及阴道微生物组成的其他指标之间的关联，并确定影响孕期维生素D状态变化的因素。
