孕期阴道微生物群落状态类型与早产相关性的网状Meta分析  

Network Meta-analysis of the Relationship between Vaginal Community Status Type and Preterm Birth During Pregnancy

作　　者：李松芳 刘芸[1] LI Songfang;LIU Yun(Department of Obstetrics and Gynecology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院妇产科,100050

出　　处：《医学研究杂志》2025年第2期139-146,共8页Journal of Medical Research

基　　金：北京市临床重点专科项目。

摘　　要：目的探究孕期不同阴道微生物群落状态类型(community state type,CST)与早产的相关性。方法搜索在PubMed、Web of Science、Elsevier Science Direct、中国知网、万方数据知识服务平台和维普数据库建库至2024年6月公开发表的关于孕期阴道CST与早产关系的文献,根据纳入与排除标准筛选文献并提取信息,所得数据使用Revman 5.4及Stata 16.0软件进行统计学分析。结果共纳入13篇队列研究,共计1959例孕妇,涉及经16S rRNA高通量基因测序分析明确的5种阴道CST,4种CST以乳酸杆菌占主导地位,分别为CSTⅠ卷曲乳酸杆菌、CSTⅡ格氏乳酸杆菌、CSTⅢ惰性乳酸杆菌和CSTⅤ詹氏乳酸杆菌,另外1种为CSTⅣ低乳酸杆菌。网状Meta分析结果显示,各CST诱发早产的风险排序由高至低为CSTⅤ>CSTⅣ>CSTⅢ>CSTⅡ>CSTⅠ,各CST两两比较,其导致早产风险的差异无统计学意义。早孕期采样组(采样孕周<14周)中,CSTⅣ与CSTⅠ比较增加了早产风险,差异有统计学意义(P<0.05)。亚裔人群中导致早产高风险菌群高危排序为CSTⅤ>CSTⅡ>CSTⅣ>CSTⅠ>CSTⅢ,各CST组间比较差异无统计学意义。结论当前研究显示,整体孕期各类阴道CST导致早产风险的差异无统计学意义,但亚组分析显示早孕期CSVⅣ较CSTⅠ增加了早产风险,差异有统计学意义。采样孕周及种族等均可能对研究结果产生影响,需要开展更多高质量、大样本量研究,以期探讨阴道CST与早产的相关性。Objective To explore the relationship between different vaginal community state type(CST)and preterm birth during pregnancy.Methods Retrieved from PubMed,Web of Science,Elsevier Science Direct,CNKI,Wanfang Data Knowledge Service Platform and VIP database for published literature on the relationship between vaginal CST and preterm birth from the establishment of the database to June 2024.References were screened according to inclusion and exclusion criteria and information was extracted.The obtained data were statistically analyzed using Revman 5.4 and Stata 16.0software.Results A total of 13 cohort studies were included,involving a total of 1959 pregnant women,involving 5 vaginal CST identified by 16SrRNA high-throughput gene sequencing analysis.Four of which were dominated by Lactobacillus,they were CSTⅠcurled Lactobacillus,CSTⅡGraveli Lactobacillus,CSTⅢinert Lactobacillus and CSTⅤJenner Lactobacillus.The other one was CSTⅣlow Lactobacillus.The results of network Meta-analysis showed that the risk of preterm birth induced by each CST was ranked from highest to lowest as CSTⅤ>CSTⅣ>CSTⅢ>CSTⅡ>CSTⅠ,and there was no statistically significant difference in the risk of preterm birth caused by each CST.In the early pregnancy sampling group(sampling gestational age<14 weeks),CSTⅣincreased the risk of preterm birth compared with CSTⅠ,and the difference was statistically significant(P<0.05).In the Asian population,the highest risk of bacteria causing preterm birth was ranked as CSTⅤ>CSTⅡ>CSTⅣ>CSTⅠ>CSTⅢ,and there was no statistically significant difference among the CST groups.Conclusion The current study showed that there was no statistically significant difference in the risk of preterm birth caused by various types of vaginal CST during the whole pregnancy,but subgroup analysis showed that CSVⅣincreased the risk of preterm birth compared with CSTⅠin early pregnancy,and the difference was statistically significant.Sampling gestational age and race may influence the results of the stud

关 键 词：阴道群落状态类型 乳酸杆菌 早产 16S rRNA高通量基因测序 网状Meta分析 

分 类 号：R71[医药卫生—妇产科学]