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. 2023 Apr 12;23(1):244.
doi: 10.1186/s12884-023-05564-y.

Vaginal flora during pregnancy and subsequent risk of preterm birth or prelabor rupture of membranes: a nested case-control study from China

Xiaomei Liu #  1   2 , Shuting Si #  3 , Li Huang  1 , Meiliang Zhang  1 , Wenya Chen  2 , Liquan Wang  4 , Yunxian Yu  5   6
Affiliations

Vaginal flora during pregnancy and subsequent risk of preterm birth or prelabor rupture of membranes: a nested case-control study from China

Xiaomei Liu et al. BMC Pregnancy Childbirth. .

Abstract

Background: The findings of the association of vaginal flora with preterm birth (PTB) or prelabor rupture of membranes (PROM) were conflicts. Moreover, vaginal flora was different by ethnicity and the evidence from China was limited.

Methods: This study was a nested case control study, based on Yiwu birth cohort. We assessed vaginal microbiota in the second or third trimester, using 16S rDNA Amplicon Sequencing and explored the association between the diversity and composition of vaginal flora and PTB or PROM.

Results: We finally included 144 pregnant women. In present study, the alpha diversity of TPROM (Term prelabor rupture of membranes) samples was lower than that of full term samples (Chao1 index: P < 0.05). When we further categorized PTB (Preterm birth) into SPB (PTB without PROM) and PPROM (Preterm prelabor rupture of membranes), there was no difference between SPB and full term. In addition, we found that the proportion of PCoA2 in TPROM group was different from that in full term group and preterm group. The difference between groups was significant according to anosim analysis (R = 0.059, P < 0.001). With LEfSe (Linear discriminant analysis Effect Size) analysis, we found that the abundance of Lactobacillus in the vaginal flora of pregnant women with preterm birth was the highest (P = 0.003).

Conclusion: In Chinese pregnant women, the alpha diversity in TPROM group was significantly lower than that in both PTB and full term group. However, there was no difference between PTB and full term. Lactobacillus was the most abundant in preterm birth group. More studies should be conducted to confirm our findings.

Keywords: Prelabor rupture of membranes; Preterm birth; Vaginal flora.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The comparison of alpha diversity (Chao 1 index) among PTB, Term and TPROM
Fig. 2
Fig. 2
a The Principal coordinates analysis among PTB, Term and TPROM groups. b The analysis of similarities among PTB, Term and TPROM groups
Fig. 3
Fig. 3
Cladogram describing differentially abundant vaginal microbial observed between women subsequently experiencing PTB, Term and PPROM as identified using LEfSe analysis
See this image and copyright information in PMC

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