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分娩硬膜外镇痛与肠道微生物群之间的关联:一项前瞻性队列研究。

Association between labor epidural analgesia and gut microbiota: A prospective cohort study.

作者信息

Hu Jing-Hui, Sheng Jie, Guo Hui-Min, Liu Hong, Zhang Xinyue, Han Bing, Peng Ke, Ji Fu-Hai

机构信息

Departments of Anesthesiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Institute of Anesthesiology, Soochow University, Suzhou, Jiangsu, China.

出版信息

Heliyon. 2024 Apr 21;10(9):e29883. doi: 10.1016/j.heliyon.2024.e29883. eCollection 2024 May 15.

DOI:10.1016/j.heliyon.2024.e29883
PMID:38699036
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11064136/
Abstract

BACKGROUND

Labor epidural analgesia (LEA) may influence gut microbiota. We explored the association between LEA and gut microbiota for both mothers and their newborns.

METHODS

In this prospective cohort study, parturients aged 25-35 years with a gestational age of 37-42 weeks and planned vaginal delivery were recruited. Twenty-one parturients received LEA (the LEA group), and 24 did not (the control group). Maternal and neonatal fecal samples were collected, and the gut microbiota profiles were analyzed using the 16S rRNA gene sequencing. The impact of LEA on gut microbiota was assessed using the general liner models.

RESULTS

We showcased the gut microbiota profile from the phyla to species levels based on data on 45 mother-newborn dyads. The results of α- and β-diversity suggested significant changes in gut microbiota between the LEA and control groups. After adjusting for baseline confounders, the administration of LEA had positive correlations with (β = 91.87, adjusted  = 0.007) in mothers; LEA also had negative correlations with (β = -449.36, adjusted  = 0.015), (β = -192.55, adjusted  = 0.008), or (β = -142.62, adjusted  = 0.001) in mothers, and with (β = -2702.77, adjusted  = 0.003) in neonates.

CONCLUSION

LEA was associated with changes in maternal and neonatal gut microbiota, and future studies are still required to assess their impact on clinical outcomes and explore the mechanisms.

摘要

背景

分娩期硬膜外镇痛(LEA)可能会影响肠道微生物群。我们探讨了LEA与母亲及其新生儿肠道微生物群之间的关联。

方法

在这项前瞻性队列研究中,招募了年龄在25 - 35岁、孕周为37 - 42周且计划经阴道分娩的产妇。21名产妇接受了LEA(LEA组),24名未接受(对照组)。收集了母亲和新生儿的粪便样本,并使用16S rRNA基因测序分析肠道微生物群谱。使用一般线性模型评估LEA对肠道微生物群的影响。

结果

基于45对母婴的数据,我们展示了从门到种水平的肠道微生物群谱。α多样性和β多样性结果表明,LEA组和对照组之间的肠道微生物群有显著变化。在调整基线混杂因素后,LEA的使用与母亲的[具体指标1]呈正相关(β = 91.87,调整后P = 0.007);LEA与母亲的[具体指标2](β = -449.36,调整后P = 0.015)、[具体指标3](β = -192.55,调整后P = 0.008)或[具体指标4](β = -142.62,调整后P = 0.001)呈负相关,与新生儿的[具体指标5](β = -2702.77,调整后P = 0.003)呈负相关。

结论

LEA与母亲和新生儿肠道微生物群的变化有关,未来仍需要研究评估其对临床结局的影响并探索其机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/04e9b3e803ec/mmcfigs2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/882af01d25bc/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/fc067292658a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/f45f16f13530/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/d6ecd2369327/mmcfigs1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/04e9b3e803ec/mmcfigs2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/882af01d25bc/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/fc067292658a/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/f45f16f13530/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/d6ecd2369327/mmcfigs1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0d4/11064136/04e9b3e803ec/mmcfigs2.jpg

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Gut Microbes. 2023 Dec;15(2):2259316. doi: 10.1080/19490976.2023.2259316. Epub 2023 Oct 9.
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Modern labor epidural analgesia: implications for labor outcomes and maternal-fetal health.现代分娩硬膜外镇痛:对分娩结局和母婴健康的影响。
Am J Obstet Gynecol. 2023 May;228(5S):S1260-S1269. doi: 10.1016/j.ajog.2022.06.017. Epub 2023 Mar 20.
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A Review of the Impact of Maternal Prenatal Stress on Offspring Microbiota and Metabolites.母体产前应激对后代微生物群和代谢产物影响的综述
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Dynamic changes in gut microbiota during pregnancy among Chinese women and influencing factors: A prospective cohort study.中国女性孕期肠道微生物群的动态变化及其影响因素:一项前瞻性队列研究。
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