Department of Obstetrics, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.
Xiamen Key Laboratory of Basic and Clinical Research on Major Obstetrical Diseases, Xiamen, China.
Front Cell Infect Microbiol. 2023 Mar 9;13:1072960. doi: 10.3389/fcimb.2023.1072960. eCollection 2023.
Evaluation of the therapeutic effects of cerclage on preterm birth (PTB) caused by cervical incompetence remains challenging. The vaginal microbiome is associated with preterm births. Thus, this study aimed to analyse the vaginal microbiota of patients with cervical incompetence, explore the relationship between the composition of the vaginal microbiota before cervical cerclage and at term delivery, and assess the effect of cervical cerclage on the vaginal microbiota.
Patients (n = 30) underwent cerclage performed by the same surgical team. Vaginal swabs were obtained pre-surgery and seven days post-surgery. A gestational age-matched cohort of healthy pregnant women (n = 20) (no particular abnormality during pregnancy, delivery at term) was used as the control group and sampled during a comparable pregnancy. All collected vaginal swabs were analysed by 16S rRNA gene sequencing.
When comparing the healthy control and cervical cerclage groups, the enriched microorganism in the healthy controls was , and the enriched microorganism of the cerclage was . α diversity was significantly increased in patients who received cerclage with preterm delivery compared with those with full-term delivery, and the enriched microorganism was . A comparison before and after nonemergency cerclage suggested that the enriched microorganisms were and before surgery. After nonemergency cerclage, the enriched microorganisms were and . Vaginal microbiota diversity significantly increased, and the proportion of women with spp.-depleted microbiomes increased after emergency cerclage. Significant differences in β diversity were found between the groups. Before the emergency cerclage, the enriched microorganisms were , , and . After emergency cerclage, the enriched microorganisms were , , , , , , and .
Cerclage (particularly emergency cerclage) may alter the vaginal microbiota by increasing microbiota diversity, decreasing vaginal abundance, and increasing the abundance of pathogenic bacteria that are not conducive to pregnancy maintenance, thereby affecting surgical efficacy. Therefore, the role of the vaginal microbiome should be considered when developing treatment strategies for pregnant women with cervical incompetence.
https://www.chictr.org.cn, identifier ChiCTR2100046305.
评估宫颈机能不全导致的早产（PTB）的环扎治疗效果仍然具有挑战性。阴道微生物群与早产有关。因此，本研究旨在分析宫颈机能不全患者的阴道微生物群，探讨宫颈环扎术前和足月分娩时阴道微生物群的组成关系，并评估宫颈环扎术对阴道微生物群的影响。
由同一位手术团队对 30 名患者进行环扎术。术前和术后 7 天采集阴道拭子。以 20 名妊娠年龄匹配的健康孕妇（无妊娠特殊异常，足月分娩）为对照组，在类似妊娠期间采样。所有收集的阴道拭子均通过 16S rRNA 基因测序进行分析。
与健康对照组和宫颈环扎组相比，健康对照组中丰富的微生物为 ，而环扎组中丰富的微生物为 。与足月分娩相比，接受环扎术且发生早产的患者的 α 多样性显著增加，其丰富的微生物为 。非紧急环扎术前、后比较发现，术前手术丰富的微生物为 、 。非紧急环扎术后，丰富的微生物为 、 。阴道微生物多样性显著增加，紧急环扎术后 spp. 耗尽微生物组的女性比例增加。组间β多样性存在显著差异。紧急环扎术前，丰富的微生物为 、 、 。紧急环扎术后，丰富的微生物为 、 、 、 、 、 、 。
环扎术（特别是紧急环扎术）可能通过增加微生物多样性、降低阴道 丰度和增加不利于妊娠维持的致病菌丰度来改变阴道微生物群，从而影响手术效果。因此，在为宫颈机能不全孕妇制定治疗策略时，应考虑阴道微生物群的作用。
https://www.chictr.org.cn，标识符 ChiCTR2100046305。
