A Preliminary Study on the Characteristics of Reproductive Tract Flora in Patients with Recurrent Spontaneous Abortion

doi:10.12280/gjszjk.20220153

Abstract

Abstract:

Objective: To test the reproductive tract flora in patients with recurrent spontaneous abortion (RSA) and normal early pregnan women. Methods: From March 2021 to September 2021, 37 RSA patients who planned uterine cleaning in our hospital were selected as the RSA group, and 25 normal early pregnant women who planned artificial abortion as the normal early pregnant group. Bacterial 16S rRNAs in the vaginal secretions and uterine decidua tissues were tested by high-throughput sequencing. The characteristics of vaginal and uterine flora were compared between the two groups. Results: The diversity of vaginal flora was significantly increased, and the structural similarity of the flora among individuals was low in the RSA group when compared with the normal early pregnant group (both P<0.05). However, the dominant bacteria remained in Lactobacillus, and the abundance of Lactobacillus was significantly decreased in the RSA group (both P<0.05). The abundances of Gardnerella, Prevotella, Megasphaera, Dialister and Anaerococcus in the vagina of RSA group was significantly higher than those of the normal early pregnant group (all P>0.05). There were no significant changes in the diversity of uterine flora and the structural similarity of uterine flora among the individuals of the RSA group (P>0.05). However, the dominant bacteria was changed. The dominant bacteria was Lactobacillus_crispatus in the normal early pregnant group, while it was Lactobacillus_iners in the RSA group. The abundance of Bifidobacterium_bifidum and uncultured_Acinetobacter_sp decreased significantly in the uterine flora of RSA group (P<0.05), while the abundance of Bacteroides, Escherichia_Shigella and Ruminococcus_torques_group increased significantly (P<0.05). Conclusions: The vaginal and uterine microflora can be tested. The bacterial diversity of uterus was higher than that of vagina, but the abundance of dominant bacteria in the uterus was lower. The upward colonization of vaginal bacteria may be related to the formation of uterine flora. The specific bacterial flora in uterus, especially the change of dominant bacteria and the emergence of pathogenic bacteria, may be related to the occurrence of RSA.

Key words: Abortion,habitual, Reproductive tract infections, Microbial consortia, Vagina, Uterus

LIN Kai-li, GUO Jie, REN Shu-qing, SONG Dian-rong, ZHANG Ji-wen, ZHAO Lin, LU Di, WANG Run-jing. A Preliminary Study on the Characteristics of Reproductive Tract Flora in Patients with Recurrent Spontaneous Abortion[J]. Journal of International Reproductive Health/Family Planning, 2022, 41(3): 177-183.

Figures/Tables 16

References 18

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组别	n	年龄（岁）	BMI（kg/m²）	停经时间（d）	孕囊直径（cm）	孕次（次）	产次（次）
正常早孕组	25	29.60±3.75	21.93±0.88	53.72±3.75	2.23±0.63	2.92±0.86	1（0,1）
RSA组	37	30.81±3.53	22.21±1.07	55.24±3.83	2.44±0.91	3.16±0.75	0（0,1）
t或z		1.292	1.093	1.526	1.005	1.162	1.762
P		0.201	0.279	0.132	0.319	0.250	0.078

组别	n	年龄（岁）	BMI（kg/m²）	停经时间（d）	孕囊直径（cm）	孕次（次）	产次（次）
正常早孕组	25	29.60±3.75	21.93±0.88	53.72±3.75	2.23±0.63	2.92±0.86	1（0,1）
RSA组	37	30.81±3.53	22.21±1.07	55.24±3.83	2.44±0.91	3.16±0.75	0（0,1）
t或z		1.292	1.093	1.526	1.005	1.162	1.762
P		0.201	0.279	0.132	0.319	0.250	0.078

组别样本来源		有效序列（条）	Features（个）	门（种）	纲（种）	目（种）	科（种）	属（种）	种（种）
正常早孕组	阴道	1 988 319	670	21	36	69	117	221	303
	宫腔	1 792 935	5 055	37	101	233	377	799	1 173
RSA组	阴道	2 789 083	1 791	23	42	80	144	350	526
	宫腔	2 703 617	6 398	33	88	209	360	776	1 612

组别样本来源		有效序列（条）	Features（个）	门（种）	纲（种）	目（种）	科（种）	属（种）	种（种）
正常早孕组	阴道	1 988 319	670	21	36	69	117	221	303
	宫腔	1 792 935	5 055	37	101	233	377	799	1 173
RSA组	阴道	2 789 083	1 791	23	42	80	144	350	526
	宫腔	2 703 617	6 398	33	88	209	360	776	1 612

组别	样本来源	n	Observed	Chao 1	Shannon	Good’s Coverage
正常早孕组	阴道	25	45.00（38.00,65.50）	48.56（43.07,67.04）	0.65（0.19,1.48）	1.00
	宫腔	25	166.00（104.50,236.50）	171.67（107.28,237.34）	4.30（3.08,6.19）	1.00
	Z（P）		5.366（0.000）	5.229（0.000）	5.899（0.000）	-
RSA组	阴道	37	95.00（68.50,117.50）	99.07（72.22,140.45）	1.08（0.56,1.85）	1.00
	宫腔	37	134.00（104.00,217.50）	143.00（109.80,234.47）	5.48（3.57,5.96）	1.00
	Z（P）		3.514（0.000）	3.049（0.002）	6.508（0.000）	-