The influence of dysbiotic disorders and local inflammatory reactions in the reproductive tract on the development of preterm birth

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Abstract

Objective: To investigate how the state of microbiocenosis and the expression profile of immune response genes in the reproductive tract of pregnant women affect the occurrence of preterm birth.

Materials and methods: This study included 228 women who were divided into groups based on gestational age at delivery. Fifty-two patients gave birth at a gestational age of 22.0–27.6 weeks, 56 at a gestational age of 28.0–31.6 weeks, 60 at a gestational age of 32.0–33.6 weeks, and 60 at a gestational age of 34.0–37.0 weeks. Each group was divided into subgroups categorized according to whether they had preterm prelabor rupture of the membranes (PPROM) or spontaneous onset of labor (SPB) without PPROM. Subgroups included women who delivered at 22.0–27.6 weeks (PPROM n=28, SPB n=24), 28.0–31.6 weeks (PPROM n=30, SPB n=26), 32.0–33.6 weeks (PPROM n=35, SPB n=25), and 34.0–37.0 weeks (PPROM n=32, SPB n=28). A total of 125 patients with PPROM and 103 with SPB without PPROM were enrolled. The control groups consisted of pregnant women with threatened preterm birth who delivered at term (n=80) and those with a normal pregnancy who delivered at 37.0–41.0 weeks (n=72). All patients were tested for vaginal microbiocenosis using the Femoflor method with determination of local inflammatory response by measuring mRNA expression levels of cytokine genes in vaginal scrapings.

Results: There were significant differences between the groups of women with preterm birth with and without PPROM and those with a normal pregnancy. The incidence of dysbiosis combined with local inflammation was higher in women with spontaneous onset of labor (p=5.02×10-15) and with PPROM (p=2.01×10-15). Normocenosis was significantly more common in women with a normal pregnancy compared to those with spontaneous onset of labor (p=3.3×10-18) and with PPROM (p=1.2×10-21).

Conclusion: Dysbiotic disorders without local inflammation are not significant prognostic factors for preterm births. To accurately predict this risk, a comprehensive assessment of microbiocenosis and local inflammation in the vagina should be performed.

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About the authors

Marzhanat К. Medzhidova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: marzhana-m@yandex.ru
ORCID iD: 0000-0001-6938-4207
SPIN-code: 5942-2320
Scopus Author ID: 57191960453
ResearcherId: GRR-7195-2022

PhD, Doctoral Student

Russian Federation, Moscow

Victor L. Tyutyunnik

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: tioutiounnik@mail.ru
ORCID iD: 0000-0002-5830-5099
SPIN-code: 1963-1359
Scopus Author ID: 56190621500
ResearcherId: B-2364-2015

Professor, Dr. Med. Sci., Leading Researcher at the Center for Scientific and Clinical Research

Russian Federation, Moscow

Natalia E. Kan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: kan-med@mail.ru
ORCID iD: 0000-0001-5087-5946
SPIN-code: 5378-8437
Scopus Author ID: 57008835600
ResearcherId: B-2370-2015

Professor, Dr. Med. Sci., Deputy Director of Science

Russian Federation, Moscow

Andrey E. Donnikov

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: donnikov@dna-technology.ru
ORCID iD: 0000-0003-3504-2406

PhD, Head of the Laboratory of Molecular Genetic Methods

Russian Federation, Moscow

Olga I. Mikhailova

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: omikhaylova@gmail.com
ORCID iD: 0000-0001-7569-8704

PhD, Researcher, 2nd Obstetric Physiology Department

Russian Federation, Moscow

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Supplementary files

Supplementary Files
Action
1. JATS XML
2. Fig. 1. State of microbiocenosis in patients with PP and physiologic pregnancy (a - spontaneous PP at 22.0-37.0 weeks; b - PPO at 22.0-37.0 weeks; c - threatened PP at 22.0-37.0 weeks; d - physiologic pregnancy)

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3. Fig. 2. State of microbiocenosis in patients with PR at different gestation periods

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