Kacerovsky Marian, Pliskova Lenka, Bolehovska Radka, Lesko Daniel, Gerychova Romana, Janku Petr, Matlak Petr, Simetka Ondrej, Stranik Jaroslav, Faist Tomas, Mls Jan, Vescicik Peter, Jacobsson Bo, Musilova Ivana
Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Charles University Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic.
Biomedical Research Center, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic.
PLoS One. 2021 Jan 22;16(1):e0245937. doi: 10.1371/journal.pone.0245937. eCollection 2021.
To determine the association between microbial invasion of the amniotic cavity (MIAC) and/or intra-amniotic inflammation (IAI) and the cervical prevalence of Gardnerella vaginalis DNA in pregnancies with preterm prelabor rupture of membrane (PPROM).
In total, 405 women with singleton pregnancies complicated with PPROM were included. Cervical fluid and amniotic fluid samples were collected at the time of admission. Bacterial and G. vaginalis DNA were assessed in the cervical fluid samples using quantitative PCR technique. Concentrations of interleukin-6 and MIAC were evaluated in the amniotic fluid samples. Loads of G. vaginalis DNA ≥ 1% of the total cervical bacterial DNA were used to define the cervical prevalence of G. vaginalis as abundant. Based on the MIAC and IAI, women were categorized into four groups: with intra-amniotic infection (both MIAC and IAI), with sterile IAI (IAI without MIAC), with MIAC without IAI, and without either MIAC or IAI.
The presence of the abundant cervical G. vaginalis was related to MIAC (with: 65% vs. without: 44%; p = 0.0004) but not IAI (with: 52% vs. without: 48%; p = 0.70). Women with MIAC without IAI had the highest load of the cervical G. vaginalis DNA (median 2.0 × 104 copies DNA/mL) and the highest presence of abundant cervical G. vaginalis (73%).
In women with PPROM, the presence of cervical G. vaginalis was associated with MIAC, mainly without the concurrent presence of IAI.
确定羊膜腔微生物入侵（MIAC）和/或羊膜腔内炎症（IAI）与胎膜早破（PPROM）妊娠中阴道加德纳菌DNA宫颈患病率之间的关联。
总共纳入405名单胎妊娠合并PPROM的女性。入院时采集宫颈液和羊水样本。使用定量PCR技术评估宫颈液样本中的细菌和阴道加德纳菌DNA。评估羊水样本中白细胞介素-6浓度和MIAC情况。阴道加德纳菌DNA负荷≥宫颈细菌总DNA的1%被用来定义阴道加德纳菌宫颈高患病率。根据MIAC和IAI情况，将女性分为四组：羊膜腔内感染组（MIAC和IAI均有）、无菌性IAI组（有IAI但无MIAC）、有MIAC但无IAI组、既无MIAC也无IAI组。
宫颈阴道加德纳菌高患病率与MIAC有关（有：65% 对比 无：44%；p = 0.0004），但与IAI无关（有：52% 对比 无：48%；p = 0.70）。有MIAC但无IAI的女性宫颈阴道加德纳菌DNA负荷最高（中位数为2.0×104拷贝DNA/mL），宫颈阴道加德纳菌高患病率也最高（73%）。
在PPROM女性中，宫颈阴道加德纳菌的存在与MIAC有关，主要是在无并发IAI的情况下。
