妊娠期糖尿病阴道菌群改变及其与围产儿不良妊娠结局的关系探讨  

Changes in Vaginal Microbiota in Gestational Diabetes Mellitus and Its Relationship with Adverse Perinatal Outcomes

作　　者：王果果 WANG Guoguo(Laboratory Department,Luoyang Peony Maternal and Child Hospital,Luoyang Henan 471000,China)

机构地区：[1]洛阳牡丹妇产医院检验科,河南洛阳471000

出　　处：《临床研究》2025年第4期109-112,共4页Clinical Research

摘　　要：目的探讨妊娠期糖尿病(GDM)阴道菌群改变情况,分析其与围产儿不良妊娠结局的关系。方法选取2019年2月至2023年1月在洛阳牡丹妇产医院就诊的112例GDM患者为研究组,另选取同期112例健康孕妇作为对照组。依据阴道菌群失调情况和围产儿妊娠结局,将研究组分为阴道菌群异常组(57例)与阴道菌群正常组(55例)、良好结局组(81例)与不良结局组(31例)。比较研究组与对照组阴道菌群分布情况。比较阴道菌群异常组与阴道菌群正常组妊娠结局,良好结局组与不良结局组一般资料和阴道菌群分布情况。分析影响GDM患者围产儿不良结局的影响因素。结果研究组乳酸杆菌占比低于对照组(P<0.05),革兰阳性杆菌、革兰阴性杆菌、革兰阳性球菌、大肠埃希菌、白色假丝酵母菌、菌群密度为Ⅰ/Ⅳ级、菌群多样性为Ⅰ/Ⅳ级菌群失调、pH>4.5占比高于对照组(P<0.05);阴道菌群异常组围产儿不良妊娠结局为早产、新生儿黄疸、新生儿感染的占比高于阴道菌群正常组(P<0.05);年龄>35岁、糖化血红蛋白(HbA1c)升高、空腹血糖升高、乳酸杆菌减少、革兰阳性杆菌、革兰阴性杆菌、革兰阳性球菌、大肠埃希菌、白色假丝酵母菌、阴道菌群密度为Ⅰ/Ⅳ级、阴道菌群多样性为Ⅰ/Ⅳ级、阴道菌群失调、pH>4.5均是GDM围产儿不良妊娠结局的影响因素(P<0.05)。结论GDM患者阴道菌群、微生态变化与围产儿不良妊娠结局有关。Objective To explore the changes in vaginal microbiota in patients with gestational diabetes mellitus(GDM)and analyze its relationship with adverse perinatal outcomes.Methods A total of 112 GDM patients treated at Luoyang Peony Maternal and Child Hospital from February 2019 to January 2023 were selected as the study group,and another 112 healthy pregnant women were chosen as the control group.Based on the condition of vaginal dysbiosis and perinatal pregnancy outcomes,the study group was divided into a vaginal dysbiosis group(57 cases)and a normal vaginal microbiota group(55 cases),as well as a good outcome group(81 cases)and a poor outcome group(31 cases).The distribution of vaginal microbiota in the study group was compared to that in the control group.The pregnancy outcomes of the vaginal dysbiosis group were compared with those of the normal vaginal microbiota group,and the general information and vaginal microbiota distribution of the good outcome group were compared with those of the poor outcome group.Factors affecting adverse outcomes in perinatal infants of GDM patients were analyzed.Results The proportion of Lactobacillus in the study group was lower than that in the control group(P<0.05),while the proportions of Gram-positive rods,Gram-negative rods,Gram-positive cocci,Escherichia coli,Candida albicans,with a microbiota density of levelⅠ/Ⅳ,microbiota diversity of levelⅠ/Ⅳdysbiosis,and pH>4.5 were higher than those in the control group(P<0.05).The incidence of adverse pregnancy outcomes such as preterm birth,neonatal jaundice,and neonatal infection in the vaginal dysbiosis group was higher than that in the normal vaginal microbiota group(P<0.05).Factors such as age>35 years,elevated glycated hemoglobin(HbA1c),elevated fasting blood glucose,reduced Lactobacillus,increased Gram-positive rods,Gram-negative rods,Gram-positive cocci,Escherichia coli,Candida albicans,a vaginal microbiota density of levelⅠ/Ⅳ,microbiota diversity of levelⅠ/Ⅳdysbiosis,and pH>4.5 were all identified as influencing

关 键 词：妊娠期糖尿病 阴道菌群 围产儿 不良妊娠结局 

分 类 号：R714.256[医药卫生—妇产科学]