高龄孕早期阴道菌群改变及其与自然流产的关系探讨  

The relationship between vaginal flora changes and spontaneous abortion in early pregnancy at advanced age

作　　者：何丽[1] 伍丽[1] 朱晓芳 黄婵 HE Li;WU Li;ZHU Xiao-fang;HUANG Chan(Obstetrics and Gynecology,Women and Children's Hospital of Chongqing Medical University,Chongqing 401147,China;不详)

机构地区：[1]重庆医科大学附属妇女儿童医院妇产科,重庆401147

出　　处：《中国微生态学杂志》2023年第3期322-326,330,共6页Chinese Journal of Microecology

基　　金：重庆市科卫联合医学科研项目(2021MSXM124)。

摘　　要：目的探讨高龄孕早期阴道菌群改变及其与自然流产的关系。方法将214例高龄孕早期孕妇、214例健康普查的同年龄段妇女、214例年龄<35岁的孕早期孕妇分别设为A组、B组、C组。检测阴道菌群属水平相对丰度、密集度、多样性等情况。随访至妊娠结束,记录A组、C组自然流产率。分析高龄孕早期孕妇自然流产的影响因素。结果A组乳酸杆菌属、普雷沃菌属相对丰度低于B组和C组(P<0.001),奇异菌属、加德纳菌属相对丰度高于B组和C组(P<0.001)。A组阴道菌群密集度Ⅰ级/Ⅳ级、Chao指数、Shannon-Wiener指数高于B组和C组(P<0.05)。A组自然流产率为25.2%,流产组奇异菌属、加德纳菌属相对丰度高于未流产组(P<0.05),乳酸杆菌属、普雷沃菌属相对丰度低于未流产组(P<0.05),密集度Ⅰ/Ⅳ级、Chao指数、Shannon-Wiener指数高于未流产组(P<0.05)。A组自然流产者奇异菌属、加德纳菌属相对丰度高于C组自然流产者(P<0.05),乳酸杆菌属、普雷沃菌属相对丰度低于C组自然流产者(P<0.05),密集度Ⅰ/Ⅳ级、Chao指数、Shannon-Wiener指数高于C组自然流产者(P<0.05)。多因素logistic回归分析发现,乳酸杆菌属、普雷沃菌属、奇异菌属、加德纳菌属、密集度Ⅰ级/Ⅳ级、Chao指数、Shannon-Wiener指数、流产史、焦虑自评量表评分≥50分是高龄孕早期孕妇自然流产的影响因素(P<0.05)。结论高龄孕早期孕妇阴道有益菌减少,密集度及多样性增加,阴道菌群失衡可能增加自然流产的风险。Objective To investigate the relationship between vaginal flora change and spontaneous abortion in pregnant women during early pregnancy at advanced maternal age.Methods Two hundred and fourteen pregnant women of advanced age in early pregnancy,214 women of the same age group and 214 early pregnant women at age of<35 years were set as group A,group B and group C,respectively.The relative abundance,density and diversity of vaginal flora at genus level were detected.Follow-up was carried out till the end of pregnancy.The spontaneous abortion rates in the group A and group C were recorded.The influencing factors of spontaneous abortion in early pregnant women of advanced age was analyzed.Results The relative abundances of Lactobacillus and Prevotella in the group A were lower(P<0.001),while those of Mirabilis and Gardnerella were higher than those in the group B and group C,respectively(P<0.001).The density of vaginal microflora grade Ⅰ/Ⅳ,Chao index and Shannon-Wiener index in group A were higher than those in group B and group C,respectively(P<0.05).The spontaneous abortion rate in the group A was 25.2%;the relative abundances of Mirabilis and Gardnerella were higher(P<0.05),while those of Lactobacillus and Prevotella were lower than those in the non abortion group(P<0.05),respectively,but the density Ⅰ/Ⅳ,Chao index and Shannon-Wiener index were higher than those in the non-abortion group(P<0.05).The relative abundances Mirabilis and Gardnerella of women with spontaneous abortion in group A were higher(P<0.05),while those of Lactobacillus and Prevotella were lower than those in group C respectively(P<0.05),but the density Ⅰ/Ⅳ,Chao index and Shannon-Wiener index were higher than those in group C(P<0.05),respectively.Multivariate logistic regression analysis showed that Lactobacillus,Prevotella,Mirabilis,Gardnerella,grade Ⅰ/Ⅳ density,Chao index,Shannon-Wiener index,abortion history and self rating anxiety scale score≥50 points were the influencing factors of spontaneous abortion in early pregnant wo

关 键 词：高龄孕妇 孕早期 阴道菌群 自然流产 

分 类 号：R714.21[医药卫生—妇产科学]