Department of Obstetrics and Gynecology, Federal University of Jundiaí, São Paulo, Brazil.
Department of Obstetrics, Federal University of São Paulo, São Paulo, Brazil.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):5383-5388. doi: 10.1080/14767058.2021.1879786. Epub 2021 Feb 1.
Predictors of spontaneous preterm birth in primigravid women remain undetermined.
We evaluated whether biomarkers in vaginal secretions and/or differences in the dominant bacterium in the vaginal microbiome predicted the risk for spontaneous preterm birth in primigravid women with a cervical length >25mm.
In a prospective study, 146 second trimester pregnant women with their first conception and a cervix >25mm were enrolled. The vaginal microbiome composition was characterized by analysis of 16S ribosomal RNA gene sequences. The concentrations of d- and l-lactic acid, matrix metalloproteinase (MMP) 2, 8 and 9 and tissue inhibitor of metalloproteinase (TIMP) 1 and 2 in vaginal secretions were measured by ELISA. Cervical length was determined by vaginal ultrasonography. Pregnancy outcome data were subsequently collected. There was a spontaneous preterm birth (SPTB) in 13 women (8.9%) while in an additional 8 women (5.5%) preterm delivery was medically indicated. was the dominant vaginal bacterium in 61.5% of women with a SPTB but only in 31.2% of those who delivered at term ( = .0354). The vaginal concentration of TIMP-1 ( = .0419) and L-lactic acid ( = .0495) was higher in women with a SPTB as compared to those who delivered at term. dominance was associated with elevated levels of TIMP-1 ( = .0434) and TIMP-2 ( = .0161) and lower levels of D-lactic acid ( < .0001) compared to when was dominant.
In this exploratory study of primigravid women, elevations in vaginal TIMP-1 and L- lactic acid and dominance in the vaginal microbiome are associated with an increased occurrence of SPTB.
初产妇自发性早产的预测因素仍未确定。
我们评估了阴道分泌物中的生物标志物和/或阴道微生物组中优势菌的差异是否可以预测宫颈长度>25mm 的初产妇自发性早产的风险。
在一项前瞻性研究中，纳入了 146 名初产妇，她们均处于妊娠中期，且首次妊娠，宫颈长度>25mm。通过 16S 核糖体 RNA 基因序列分析来描述阴道微生物组组成。通过 ELISA 测量阴道分泌物中 d-和 l-乳酸、基质金属蛋白酶（MMP）2、8 和 9 以及金属蛋白酶组织抑制剂（TIMP）1 和 2 的浓度。通过阴道超声检查确定宫颈长度。随后收集妊娠结局数据。13 名妇女（8.9%）发生自发性早产（SPTB），8 名妇女（5.5%）因早产而接受医疗干预。在发生 SPTB 的妇女中，占主导地位的阴道细菌为，而在足月分娩的妇女中仅占 31.2%（ = .0354）。与足月分娩的妇女相比，发生 SPTB 的妇女阴道中 TIMP-1（ = .0419）和 L-乳酸（ = .0495）的浓度更高。与 占主导地位相比， dominance 与 TIMP-1（ = .0434）和 TIMP-2（ = .0161）水平升高以及 D-乳酸水平降低（ < .0001）相关。
在这项对初产妇的探索性研究中，阴道 TIMP-1 和 L-乳酸的升高和阴道微生物组中 的主导地位与 SPTB 的发生增加有关。
