Rafat Dalia, Agrawal Anubha, Singh Sunita, Khalid Shamsi, Khan Asad U, Nawab Tabassum
Department of Obstetrics & Gynaecology, Faculty of Medicine, Jawaharlal Nehru Medical College, AMU, Aligarh, UP India.
Interdisciplinary Biotechnology Unit, Faculty of Life Sciences, AMU, Aligarh, UP India.
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):494-503. doi: 10.1007/s13224-024-02095-0. Epub 2025 Jan 17.
Vaginal flora alterations (AVF) have been implicated in both health and disease states. Few studies have looked at the connection between AVF and adverse fetomaternal outcomes(AFMOs), and even fewer have assessed their concurrent link with gestational diabetes mellitus (GDM). Therefore, this study investigated the association between AVF and GDM and their impact on AFMOs. In addition, we assessed the antimicrobial resistance(AMR) of isolated pathogens and sought to identify the associated risk factors.
This prospective, cross-sectional study was conducted among 640 pregnant women; divided into two groups, GDM and non-GDM. We administered standardized questionnaires to collect data regarding sociodemographic and clinical characteristics; collected vaginal samples at 26-38 weeks for Nugent scoring and determination of bacterial and fungal species; assessed AMR of the isolated pathogens and followed up patients for assessment of AFMOs.
We found AVF in 47.5% of participants, with 36.6% having single AVF and 10.9% mixed AVF. There was a significantly higher occurrence of all studied AVF subtypes in GDM group. We noted high prevalence of AMR and MDR among isolated pathogens. We also found association of AFMO with different AVF subtypes, with higher prevalence of AFMOs among participants with mixed AVF.
The impact of AVF on AFMOs, along with their association with hyperglycemia; provides a potential avenue for working on minimizing AFMOs, which will eventually contribute toward improving the health of both the women and their offspring. The high prevalence of AVF and AMR in this study, calls for effective infection control and stewardship programmes.
The online version contains supplementary material available at 10.1007/s13224-024-02095-0.
阴道菌群改变（AVF）与健康和疾病状态均有关联。很少有研究探讨AVF与不良母胎结局（AFMOs）之间的联系，评估它们与妊娠期糖尿病（GDM）并发关系的研究更少。因此，本研究调查了AVF与GDM之间的关联及其对AFMOs的影响。此外，我们评估了分离出的病原体的抗菌药物耐药性（AMR），并试图确定相关危险因素。
本前瞻性横断面研究在640名孕妇中进行；分为两组，GDM组和非GDM组。我们发放标准化问卷以收集社会人口学和临床特征数据；在孕26 - 38周采集阴道样本进行 Nugent评分并确定细菌和真菌种类；评估分离出的病原体的AMR，并对患者进行随访以评估AFMOs。
我们在47.5%的参与者中发现了AVF，其中36.6%为单一AVF，10.9%为混合AVF。GDM组中所有研究的AVF亚型发生率均显著更高。我们注意到分离出的病原体中AMR和多重耐药（MDR）的高流行率。我们还发现AFMO与不同的AVF亚型有关联，混合AVF参与者中AFMO的患病率更高。
AVF对AFMOs的影响及其与高血糖的关联；为努力减少AFMOs提供了一条潜在途径，这最终将有助于改善妇女及其后代的健康。本研究中AVF和AMR的高流行率，呼吁实施有效的感染控制和管理计划。
在线版本包含可在10.1007/s13224 - 024 - 02095 - 0获取的补充材料。
