The association between vaginal bacterial composition and miscarriage: a nested case-control study.
First trimester miscarriage
second trimester miscarriage
vaginal bacteria
vaginal microbiome
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
accepted:
25
09
2019
pubmed:
2
10
2019
medline:
6
2
2020
entrez:
2
10
2019
Statut:
ppublish
Résumé
To characterise vaginal bacterial composition in early pregnancy and investigate its relationship with first and second trimester miscarriages. Nested case-control study. Queen Charlotte's and Chelsea Hospital, Imperial College Healthcare NHS Trust, London. 161 pregnancies: 64 resulting in first trimester miscarriage, 14 in second trimester miscarriage and 83 term pregnancies. Prospective profiling and comparison of vaginal bacteria composition using 16S rRNA gene-based metataxonomics from 5 weeks' gestation in pregnancies ending in miscarriage or uncomplicated term deliveries matched for age, gestation and body mass index. Relative vaginal bacteria abundance, diversity and richness. Pregnancy outcomes defined as first or second trimester miscarriage, or uncomplicated term delivery. First trimester miscarriage associated with reduced prevalence of Lactobacillus spp.-dominated vaginal microbiota classified using hierarchical clustering analysis (65.6 versus 87.7%; P = 0.005), higher alpha diversity (mean Inverse Simpson Index 2.5 [95% confidence interval 1.8-3.0] versus 1.5 [1.3-1.7], P = 0.003) and higher richness 25.1 (18.5-31.7) versus 16.7 (13.4-20), P = 0.017), compared with viable pregnancies. This was independent of vaginal bleeding and observable before first trimester miscarriage diagnosis (P = 0.015). Incomplete/complete miscarriage associated with higher proportions of Lactobacillus spp.-depleted communities compared with missed miscarriage. Early pregnancy vaginal bacterial stability was similar between miscarriage and term pregnancies. These findings associate the bacterial component of vaginal microbiota with first trimester miscarriage and indicate suboptimal community composition is established in early pregnancy. While further studies are required to elucidate the mechanism, vaginal bacterial composition may represent a modifiable risk factor for first trimester miscarriage. Vaginal bacterial composition in first trimester miscarriage is associated with reduced Lactobacillus spp. abundance and is independent of vaginal bleeding.
Identifiants
pubmed: 31573753
doi: 10.1111/1471-0528.15972
pmc: PMC6972675
doi:
Substances chimiques
RNA, Ribosomal, 16S
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
264-274Subventions
Organisme : Tommy's National Centre for Miscarriage Research
ID : P62774
Pays : International
Organisme : UK National Institute for Health Research Biomedical Research Centre
ID : P45272
Pays : International
Organisme : March of Dimes European Preterm Birth Research Centre at Imperial College London
Pays : International
Organisme : NIHR CLAHRC NWL (Collaboration for Leadership in Applied Health Research & Care, North-West London)
Pays : International
Organisme : Medical Research Council
ID : MR/L009226/1
Pays : United Kingdom
Informations de copyright
© 2019 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.
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