The influence of dysbiotic disorders and local inflammatory reactions in the reproductive tract on the development of preterm birth
- Авторлар: Medzhidova M.К.1, Tyutyunnik V.L.1, Kan N.E.1, Donnikov A.E.1, Mikhailova O.I.1
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Мекемелер:
- Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
- Шығарылым: № 5 (2024)
- Беттер: 74-81
- Бөлім: Original Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/633732
- DOI: https://doi.org/10.18565/aig.2024.14
- ID: 633732
Дәйексөз келтіру
Ашық рұқсат
Рұқсат берілді
Аннотация
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.
Толық мәтін
Авторлар туралы
Marzhanat Medzhidova
Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia
Хат алмасуға жауапты Автор.
Email: marzhana-m@yandex.ru
ORCID iD: 0000-0001-6938-4207
SPIN-код: 5942-2320
Scopus Author ID: 57191960453
ResearcherId: GRR-7195-2022
PhD, Doctoral Student
Ресей, MoscowVictor 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-код: 1963-1359
Scopus Author ID: 56190621500
ResearcherId: B-2364-2015
Professor, Dr. Med. Sci., Leading Researcher at the Center for Scientific and Clinical Research
Ресей, MoscowNatalia 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-код: 5378-8437
Scopus Author ID: 57008835600
ResearcherId: B-2370-2015
Professor, Dr. Med. Sci., Deputy Director of Science
Ресей, MoscowAndrey 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
Ресей, MoscowOlga 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
Ресей, MoscowӘдебиет тізімі
- Министерство здравоохранения Российской Федерации. Клинические рекомендации. Преждевременные роды. М.; 2020. 54 с. [Ministry of Health of the Russian Federation. Clinical guidelines. Preterm birth. Moscow; 2020. 54 p. (in Russian)].
- Dauengauer-Kirlienė S., Domarkienė I., Pilypienė I., Žukauskaitė G., Kučinskas V., Matulevičienė A. Causes of preterm birth: Genetic factors in preterm birth and preterm infant phenotypes. J. Obstet. Gynaecol. Res. 2023; 49(3): 781-93. https://dx.doi.org/10.1111/jog.15516.
- da Fonseca E.B., Damião R., Moreira D.A. Preterm birth prevention. Best Pract. Res. Clin. Obstet. Gynaecol. 2020; 69: 40-9. https://dx.doi.org/10.1016/j.bpobgyn.2020.09.003.
- Schoenmakers S., Aagaard K., Borenstein-Levin L., Kawaza K., van der Meeren L.E., Mol B.W. et al. Editorial: Preterm birth and placental pathology. Front. Endocrinol (Lausanne). 2023; 14: 1168185. https://dx.doi.org/10.3389/fendo.2023.1168185.
- Couture C., Brien M.E., Boufaied I., Duval C., Soglio D.D., Enninga E.A.L. et al. Proinflammatory changes in the maternal circulation, maternal-fetal interface, and placental transcriptome in preterm birth. Am. J. Obstet. Gynecol. 2023; 228(3): 332.e1-332.e17. https://dx.doi.org/10.1016/
- j.ajog.2022.08.035.
- Белоусова В.С., Стрижаков А.Н., Свитич О.А., Тимохина Е.В., Кукина П.И., Богомазова И.М., Пицхелаури Е.Г. Преждевременные роды: причины, патогенез, тактика. Акушерство и гинекология. 2020; 2: 82-7. [Belousova V.S., Strizhakov A.N., Svitich O.A., Timokhina E.V., Kukina P.I., Bogomazova I.M., Pitskhelauri E.G. Preterm birth: causes, pathogenesis, and management. Obstetrics and Gynecology. 2020; (2): 82-7. (in Russian)]. https://dx.doi.org/10.18565/aig.2020.2.82-87.
- Paquette A.G., MacDonald J., Bammler T., Day D.B., Loftus C.T., Buth E. et al. Placental transcriptomic signatures of spontaneous preterm birth. Am. J. Obstet. Gynecol. 2023; 228(1): 73.e1-73.e18. https://dx.doi.org/10.1016/j.ajog.2022.07.015.
- Dudley D.J., Ennen C.S. The vexing problem of preterm birth prevention. JAMA. 2023; 330(4): 323-5. https://dx.doi.org/10.1001/jama.2023.7244.
- Moosa Y., Kwon D., de Oliveira T., Wong E.B. Determinants of vaginal microbiota composition. Front. Cell. Infect. Microbiol. 2020; 10: 467. https://dx.doi.org/10.3389/fcimb.2020.00467.
- Lamont R.F. Spontaneous preterm labour that leads to preterm birth: An update and personal reflection. Placenta. 2019; 79: 21-9. https://dx.doi.org/10.1016/j.placenta.2019.03.010.
- Kindschuh W.F., Baldini F., Liu M.C., Liao J., Meydan Y., Lee H.H. et al. Preterm birth is associated with xenobiotics and predicted by the vaginal metabolome. Nat. Microbiol. 2023; 8(2): 246-59. https://dx.doi.org/10.1038/s41564-022-01293-8.
- Rowlands S., Danielewski J.A., Tabrizi S.N., Walker S.P., Garland S.M. Microbial invasion of the amniotic cavity in midtrimester pregnancies using molecular microbiology. Am. J. Obstet. Gynecol. 2017; 217(1): 71.e1-71.e5. https://dx.doi.org/10.1016/j.ajog.2017.02.051.
- Nkhalamba L., Hampton T., Mulwafu W. Defining the neurologic consequences of preterm birth. N. Engl. J. Med. 2023; 389(19): 1826-7. https://dx.doi.org/10.1056/NEJMc2310222.
- Кан Н.Е., Салпагарова З.Х., Тютюнник В.Л., Щипицына В.С., Красный А.М. Содержание про- и антиоксидантов в капиллярной крови при преждевременных родах. Акушерство и гинекология. 2022; 1: 56-61. [Kan N.E., Salpagarova Z.Kh., Tyutyunnik V.L., Shchipitsyna V.S., Krasnyi A.M. Prooxidant and antioxidant content in capillary blood in preterm birth. Obstetrics and Gynecology. 2022; (1): 56-61 (in Russian)]. https://dx.doi.org/10.18565/aig.2022.1.56-61.
- Тютюнник В.Л., Кан Н.Е., Высоких М.Ю., Кокоева Д.Н., Донников А.Е., Сарибекова А.Г., Меджидова М.К. Возможности прогнозирования преждевременных родов путем определения содержания митохондриальной ДНК и структурно-функционального белка VDAC1. Акушерство и гинекология. 2021; 3: 58-65. [Tyutyunnik V.L., Kan N.E., Vysokikh M.Yu., Kokoeva D.N., Donnikov A.E., Saribekova A.G., Medzhidova M.К. Possibilities of predicting preterm birth using mitochondrial DNA and VDAC1 protein. Obstetrics and Gynecology. 2021; (3): 58-65 (in Russian)]. https://dx.doi.org/10.18565/aig.2021.3.58-65.
- Высоких М.Ю., Тютюнник В.Л., Кан Н.Е., Курчакова Т.А. Суханова Ю.А., Володина М.А., Тарасова Н.В., Цвиркун Д.В., Меджидова М.К., Арушанова А.Г. Диагностическая значимость определения содержания малонового диальдегида и активности каталазы при преждевременных родах. Акушерство и гинекология. 2017; 4: 62-7. [Vysokikh M.Y., Tyutyunnik V.L., Kan N.E., Kurchakova T.A., Sukhanova I.A., Volodina M.A., Tarasova N.V., Tsvirkun D.V., Medzidova M.K., Arushanova A.G. Diagnostic significance of malondialdehyde level and catalase activity evaluation in women with preterm labor. Obstetrics and Gynecology. 2017; (4): 62-7. (in Russian)]. https://dx.doi.org/10.18565/aig.2017.4.62-67.
- Красный А.М., Кан Н.Е., Тютюнник В.Л., Садекова А.А., Сарибекова А.Г., Кокоева Д.Н., Салпагарова З.Х., Меджидова М.К., Вторушина В.В., Кречетова Л.В. Прогнозирование преждевременных родов путем комбинированного определения цитокинов и внеклеточной ДНК. Акушерство и гинекология. 2019; 1: 86-91. [Krasnyi A.M., Kan N.E., Tyutyunnik V.L., Sadekova A.A., Saribekova A.G., Kokoeva D.N., Salpagarova Z.Kh., Medzhidova M.K., Vtorushina V.V., Krechetova L.V. Predicting preterm labor by combined testing of cytokines and cell-free DNA. Obstetrics and Gynecology. 2019; (1): 86-91. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.1.86-91.
- Khan W., Zaki N., Ghenimi N., Ahmad A., Bian J., Masud M.M. et al. Predicting preterm birth using explainable machine learning in a prospective cohort of nulliparous and multiparous pregnant women. PLoS One. 2023; 18(12): e0293925. https://dx.doi.org/10.1371/journal.pone.0293925.
- Areia A.L., Moura P., Mota-Pinto A.; PROSPERO Nº CRD42018089859. The role of innate immunity in spontaneous preterm labor: a systematic review. J. Reprod. Immunol. 2019; 136: 102616. https://dx.doi.org/10.1016/j.jri.2019.102616.
- Радзинский В.Е., Оразмурадов А.А., Савенкова И.В., Дамирова К.Ф., Хаддад Х. Преждевременные роды – нерешенная проблема XXI века. Кубанский научный медицинский вестник. 2020; 27(4): 27-37. [Radzinsky V.E., Orazmuradov A.A., Savenkova I.V., Damirova K.F., Haddad H. Preterm labour: an open problem in XXI century. Kuban Scientific Medical Bulletin. 2020; 27(4): 27-37. (in Russian)]. https://doi.org/10.25207/1608-6228-2020-27-4-27-37.
- Abramson J.H. WINPEPI updated: computer programs for epidemiologists, and their teaching potential. Epidemiol. Perspect. Innov. 2011; 8(1): 1. https://dx.doi.org/10.1186/1742-5573-8-1.
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