Study on vaginal microbiota in patients with missed abortion
SHI Suya BAI Huihui DU Mengyao CHENG Dongmei FAN Linyuan CHEN Suwen LIU Zhaohui
Department of Gynecology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University Maternal and Child Health Care Hospital, Beijing 100026, China
Abstract Objective To analyze the vaginal microbiota of patients with missed abortion. Methods Patients attending Beijing Obstetrics and Gynecology Hospital, Capital Medical University from September 2020 to June 2021 were selected, 30 patients with missed abortion were included in the experimental group, and 30 normal early pregnancy who planned in the control group. Furthermore, the patients with missed abortion were further divided into 16 patients with normal chromosome group, six patients with abnormal chromosome group, and eight patients with unknown chromosome group according to the results of fetal villus chromosome examination. The questionnaire was filled in and the microecology detection of vaginal secretions was performed. The baseline data and vaginal microecology indexes of the four groups were compared by single factor. Meanwhile, 16S rRNA high-throughput sequencing technology was used to analyze the differences of vaginal microflora between the four groups. Results The comparison of baseline data and microecological indicators of the four groups showed that there were statistically significant differences in whether the four groups had a history of pelvic inflammatory disease, bacterial diversity, and dominant bacteria (P＜0.05), among which the proportion of patients with a history of pelvic inflammatory disease and the age of first sexual life in the chromosome abnormality group were higher than those in the control group (P＜0.05). The proportion of patients with previous abortion history was lower than that of control group (P＜0.05). The results of OTU cluster analysis showed that, compared with the missed abortion group, the number of OTUs in the control group was more, and the bacteria community was more abundant. The results of species classification analysis showed that, compared with the control group, normal chromosome group had imbalance of different lactobacillus strains (increased Lactobacillus inners, decreased Lactobacillus unclassified), and the relative abundance of other bacteria except Lactobacillus (Gardnerella, Prevotella, Escherichia-Shigella, etc.) increased. There was no significant difference in the abundance and proportion of Lactobacillus strains in the abnormal chromosome group. The results of Alpha diversity analysis showed that there were significant differences in the flora abundance among the four groups (P＜0.05). The flora abundance of the normal chromosome group was lower than that of the control group (P＜0.05), there was no difference in the flora abundance between the abnormal chromosome group and the control group (P＞0.05). The results of β-diversity analysis and line discriminant analysis effect size analysis showed that there was not significant difference in vaginal flora among the four groups (P＞0.05). Conclusion The imbalance of vaginal microflora in patients with missed abortion may be related to the decreased relative abundance of Lactobacillus and / or the imbalance in the proportion of different Lactobacillus strains and the increased relative abundance of other bacteria except Lactobacillus (Gardnerella, Prevotella, Escherichia-Shigella, etc.) in the vaginal microflora, but its direct etiology and mechanism need further study.
SHI Suya BAI Huihui DU Mengyao CHENG Dongmei FAN Linyuan CHEN Suwen LIU Zhaohui. Study on vaginal microbiota in patients with missed abortion[J]. 中国医药导报, 2023, 20(26): 4-10.
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