Pregnancy Research Branch, Division of Obstetrics and Maternal-Fetal Medicine, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA.
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan, USA.
Microbiol Spectr. 2023 Aug 17;11(4):e0342922. doi: 10.1128/spectrum.03429-22. Epub 2023 Jul 24.
The composition of the vaginal microbiota is heavily influenced by pregnancy and may factor into pregnancy complications, including spontaneous preterm birth. However, results among studies have been inconsistent due, in part, to variation in sample sizes and ethnicity. Thus, an association between the vaginal microbiota and preterm labor continues to be debated. Yet, before assessing associations between the composition of the vaginal microbiota and preterm labor, a robust and in-depth characterization of the vaginal microbiota throughout pregnancy in the specific study population under investigation is required. Here, we report a large longitudinal study ( = 474 women, 1,862 vaginal samples) of a predominantly African-American cohort-a population that experiences a relatively high rate of pregnancy complications-evaluating associations between individual identity, gestational age, and other maternal characteristics with the composition of the vaginal microbiota throughout gestation resulting in term delivery. The principal factors influencing the composition of the vaginal microbiota in pregnancy are individual identity and gestational age at sampling. Other factors are maternal age, parity, obesity, and self-reported use. The general pattern across gestation is for the vaginal microbiota to remain or transition to a state of dominance. This pattern can be modified by maternal parity and obesity. Regardless, network analyses reveal dynamic associations among specific bacterial taxa within the vaginal ecosystem, which shift throughout the course of pregnancy. This study provides a robust foundational understanding of the vaginal microbiota in pregnancy and sets the stage for further investigation of this microbiota in obstetrical disease. There is debate regarding links between the vaginal microbiota and pregnancy complications, especially spontaneous preterm birth. Inconsistencies in results among studies are likely due to differences in sample sizes and cohort ethnicity. Ethnicity is a complicating factor because, although all bacterial taxa commonly inhabiting the vagina are present among all ethnicities, the frequencies of these taxa vary among ethnicities. Therefore, an in-depth characterization of the vaginal microbiota throughout pregnancy in the specific study population under investigation is required prior to evaluating associations between the vaginal microbiota and obstetrical disease. This initial investigation is a large longitudinal study of the vaginal microbiota throughout gestation resulting in a term delivery in a predominantly African-American cohort, a population that experiences disproportionally negative maternal-fetal health outcomes. It establishes the magnitude of associations between maternal characteristics, such as age, parity, body mass index, and self-reported use, on the vaginal microbiota in pregnancy.
阴道微生物组的组成受妊娠影响很大，并可能导致妊娠并发症，包括自发性早产。然而，由于研究中的样本量和种族差异，研究结果并不一致。因此，阴道微生物组与早产之间的关联仍存在争议。然而，在评估阴道微生物组与早产之间的关联之前，需要对特定研究人群在整个孕期的阴道微生物组进行深入的特征描述。在这里，我们报告了一项大型纵向研究（= 474 名女性，1862 个阴道样本），该研究针对的是一个主要是非洲裔美国人的队列-该人群经历妊娠并发症的相对较高的比例-评估个体身份、妊娠年龄和其他与整个孕期阴道微生物组组成相关的母亲特征与足月分娩相关的早产之间的关联。影响妊娠期间阴道微生物组组成的主要因素是个体身份和采样时的妊娠年龄。其他因素包括母亲年龄、产次、肥胖和自我报告的 使用。整个孕期的总体模式是阴道微生物组保持或转变为优势状态。这种模式可以通过母亲的产次和肥胖来改变。无论如何，网络分析显示了阴道生态系统中特定细菌分类群之间的动态关联，这些关联在整个孕期发生变化。这项研究为妊娠期间阴道微生物组提供了一个强大的基础理解，并为进一步研究产科疾病中的这种微生物组奠定了基础。
关于阴道微生物组与妊娠并发症（尤其是自发性早产）之间的联系存在争议。研究结果不一致可能是由于样本量和队列种族的差异。种族是一个复杂的因素，因为尽管所有常见于阴道的细菌分类群都存在于所有种族中，但这些分类群的频率在不同种族之间存在差异。因此，在评估阴道微生物组与产科疾病之间的关联之前，需要对特定研究人群在整个孕期的阴道微生物组进行深入的特征描述。
这项初步研究是一项大型纵向研究，对主要是非洲裔美国人队列的整个孕期的阴道微生物组进行了研究，该队列经历了不成比例的母婴健康不良结局。它确定了母亲特征（如年龄、产次、体重指数和自我报告的 使用）与妊娠期间阴道微生物组之间的关联程度。
