Ferrante Margherita, Oliveri Conti Gea, Pulvirenti Eloise, Favara Claudia, Fiore Maria, Cristaldi Antonio
Department of Medical Sciences, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy.
Department of Medical Sciences, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Italy.
Eur J Obstet Gynecol Reprod Biol. 2025 Jul;311:114007. doi: 10.1016/j.ejogrb.2025.114007. Epub 2025 Apr 26.
Vaginal microbiota is a dynamic community of bacteria, fungi, and viruses that colonize the lower genital tract. Changes in vaginal microbiota can result in obstetric complication. For example, a reduction in Lactobacilli can lead to bacterial vaginosis, which is associated with preterm birth. We performed a systematic review to investigate the association between vaginal microbiota composition during pregnancy and preterm birth risk. Scopus, Web of Science, PubMed databases were used to find published studies on the topic. The search period was between January 2014 and June 2024. A total of 2194 full research articles were screened, and finally, we included 14 full-research articles. Demographic factors, such as self-identified ethnicity, age, substance use, and gestational age, influence the vaginal microbiota were identified. The greatest diversity in the composition of the vaginal microbiota was found between the first and second trimesters of pregnancy. We found a decrease in L. crispatus, L. gasseri and L. jensenii population, with a relative increase in L. iners, which were associated with preterm birth. In addition, Ureaplasma, Mycoplasma, and Gardnerella species were associated with increased rates of preterm birth. An increase in cytokines (IL-1β, IL-6, and MIP-1β) and a decrease in β-defensin-2 values also seem to influence the preterm birth onset. In summary, we identified multiple vaginal microbiota that were associated with changes in the risk of preterm birth. Further studies should focus on demonstrating a causal relationship and identifying interventions to reduce the risk of preterm birth associated with changes in the vaginal microbiota.
阴道微生物群是定植于下生殖道的细菌、真菌和病毒的动态群落。阴道微生物群的变化可导致产科并发症。例如，乳酸杆菌减少可导致细菌性阴道病，这与早产有关。我们进行了一项系统综述，以研究孕期阴道微生物群组成与早产风险之间的关联。使用Scopus、科学网、PubMed数据库查找关于该主题的已发表研究。检索期为2014年1月至2024年6月。共筛选了2194篇完整的研究文章，最终纳入14篇完整研究文章。确定了影响阴道微生物群的人口统计学因素，如自我认定的种族、年龄、物质使用和孕周。在妊娠的第一和第二孕期之间发现阴道微生物群组成的多样性最大。我们发现卷曲乳酸杆菌、加氏乳酸杆菌和詹氏乳酸杆菌数量减少，惰性乳酸杆菌相对增加，这与早产有关。此外，脲原体、支原体和加德纳菌属与早产率增加有关。细胞因子（IL-1β、IL-6和MIP-1β）增加和β-防御素-2值降低似乎也影响早产的发生。总之，我们确定了多种与早产风险变化相关的阴道微生物群。进一步的研究应侧重于证明因果关系，并确定降低与阴道微生物群变化相关的早产风险的干预措施。
