Distribution of vaginal microbiota in women with early-onset preeclampsia complicated by preterm premature rupture of membranes and its effect on pregnancy outcomes
10.3969/j.issn.1673-4130.2024.12.008
- VernacularTitle:早发型子痫前期并发未足月胎膜早破孕妇的阴道菌群分布及其对妊娠结局的影响
- Author:
Mengmei WANG
1
;
Li SU
;
Xue LI
Author Information
1. 保定市第二医院产科,河北保定 071000
- Keywords:
early-onset preeclampsia;
preterm premature rupture of membranes;
vaginal microbiota distribution;
pregnancy outcomes
- From:
International Journal of Laboratory Medicine
2024;45(12):1448-1452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the distribution of vaginal microbiota in women with early-onset pre-eclampsia(PE)complicated by preterm premature rupture of membranes(PPROM)and the effect of differ-ent vaginal microbiota distribution on pregnancy outcomes.Methods A total of 120 pregnant women with early-onset PE admitted to this hospital from January 2019 to January 2022 were selected as the research ob-jects.Among them,67 pregnant women complicated with PPROM were selected as the observation group,and 53 pregnant women without PPROM were selected as the control group.The distribution of vaginal microflora was compared between the two groups,and the pregnancy outcomes of patients with early-onset PE complicat-ed with PPROM were analyzed.Results In terms of dominant bacteria,the proportion of Lactobacillus in the observation group was lower than that in the control group,and the proportion of Gram-positive bacilli,Gram-negative bacilli and Gram-positive cocci in the observation group were higher than that in the control group,and the differences were statistically significant(P＜0.05).In terms of pathogenic bacteria,the proportion of Glucococcus haemolyticus and Enterobacter cloacae in the observation group were higher than that in the con-trol group,and the differences were statistically significant(P＜0.05).In terms of vaginal flora density,the proportion of Ⅱ and m grade in the observation group were lower than that in the control group,and the differences were statistically significant(P＜0.05).In terms of the diversity of vaginal flora,the proportion ofⅡ and m grade in the observation group were lower than that in the control group,and the differences were statistically significant(P＜0.05).The imbalance rate of vaginal microecosystem in the observation group was 80.60％,which was higher than 45.28％in the control group,and the difference was statistically signifi-cant(x2=81.340,P＜0.001).Compared with the control group,the blood pressure was higher,24 h urine volume was lower,24 h urinary protein was higher,platelet was higher,prothrombin time and activated partial thromboplastin time were prolonged in the observation group after treatment(all P＜0.05).There were 10 cases of fetal growth restriction,8 cases of fetal intrauterine distress and 4 cases of neonatal asphyxia in the observation group,and 3 cases of fetal growth restriction,1 case of fetal intrauterine distress and 0 case of neo-natal asphyxia in the control group.The incidence of perinatal complications in the observation group(32.84％)was significantly higher than that in the control group(7.55％),and the difference was statistically significant(P＜0.05).Among 67 cases of early-onset PE complicated with PPROM,54 cases had dysbiosis(dysbiosis group)and 13 cases had normal microflora(normal microflora group).The incidence of adverse pregnancy outcomes in the dysbiosis group was 81.48％,which was higher than 46.15％in the normal micro-flora group(x2=5.089,P=0.024).Compared with the normal microflora group,the neonatal birth weight of the dysbiosis group was significantly lower(t=2.196,P=0.032),and the length of hospital stay was signifi-cantly longer(t=7.463,P＜0.001).Conclusion The imbalance of vaginal flora in women with early-onset PE complicated with PPROM may lead to adverse pregnancy outcomes.In clinical practice,it is necessary to pay attention to the changes of vaginal flora and intervene in time to reduce the risk of adverse pregnancy out-comes.
