본문 바로가기
KERD
논문KCI 등재

Prevalence of vaginal microorganisms among pregnant women according to trimester and association with preterm birth

1

조회

0

다운로드

4

인용

0

참고문헌

키워드

주제분류산부인과학

초록

Objective The aim of this study was to investigate the prevalence of abnormal vaginal microorganisms in pregnant women according to trimester, and to determine whether the presence of abnormal vaginal colonization is associated with higher risk of miscarriage or preterm delivery. Furthermore, we analyzed delivery outcomes according to individual microorganism species. Methods We included pregnant women who underwent vaginal culture during routine prenatal check-up between January 2011 and June 2016. We compared delivery outcomes according to the presence or absence of abnormal vaginal flora grouped by trimester. Results This study included 593 singleton pregnancies. We classified participants into 3 groups, according to the trimester in which vaginal culture was performed; 1st trimester (n=221), 2nd trimester (n=138), and 3rd trimester (n=234). Abnormal vaginal colonization rate significantly decreased with advancing trimester of pregnancy (21.7% for 1st, 21.0% for 2nd, 14.5% for 3rd; P=0.048). Abnormal vaginal colonization detected in the 2nd trimester but not in 1st trimester was associated with a significant increase in preterm delivery before 28 weeks of gestation (6.9% vs. 0%; P=0.006). Among abnormal vaginal flora isolated in the 2nd trimester, the presence of Klebsiella pneumonia was identified as significant microorganism associated with preterm delivery before 28 weeks of gestation (50% vs. 0.7% for K. pneumonia; P=0.029). Conclusion There is an association between abnormal vaginal colonization detected in the 2nd trimester and preterm delivery before 28 weeks. K. pneumonia has been identified as the likely causative microorganisms.

Abstract

Objective The aim of this study was to investigate the prevalence of abnormal vaginal microorganisms in pregnant women according to trimester, and to determine whether the presence of abnormal vaginal colonization is associated with higher risk of miscarriage or preterm delivery. Furthermore, we analyzed delivery outcomes according to individual microorganism species. Methods We included pregnant women who underwent vaginal culture during routine prenatal check-up between January 2011 and June 2016. We compared delivery outcomes according to the presence or absence of abnormal vaginal flora grouped by trimester. Results This study included 593 singleton pregnancies. We classified participants into 3 groups, according to the trimester in which vaginal culture was performed; 1st trimester (n=221), 2nd trimester (n=138), and 3rd trimester (n=234). Abnormal vaginal colonization rate significantly decreased with advancing trimester of pregnancy (21.7% for 1st, 21.0% for 2nd, 14.5% for 3rd; P=0.048). Abnormal vaginal colonization detected in the 2nd trimester but not in 1st trimester was associated with a significant increase in preterm delivery before 28 weeks of gestation (6.9% vs. 0%; P=0.006). Among abnormal vaginal flora isolated in the 2nd trimester, the presence of Klebsiella pneumonia was identified as significant microorganism associated with preterm delivery before 28 weeks of gestation (50% vs. 0.7% for K. pneumonia; P=0.029). Conclusion There is an association between abnormal vaginal colonization detected in the 2nd trimester and preterm delivery before 28 weeks. K. pneumonia has been identified as the likely causative microorganisms.

참고문헌 (36)

  1. Aagaard K, "A metagenomic approach to characterization of the vaginal microbiome signature in pregnancy", PLoS One, 7, pp.e36466~ (2012)[DOI]
  2. McLean NW, "Characterisation and selection of a Lactobacillus species to re-colonise the vagina of women with recurrent bacterial vaginosis", J Med Microbiol, 49, pp.543~552 (2000)[DOI]
  3. Martin HL, "Vaginal lactobacilli, microbial flora, and risk of human immunodeficiency virus type 1 and sexually transmitted disease acquisition", J Infect Dis, 180, pp.1863~1868 (1999)[DOI]
  4. Hay PE, "Abnormal bacterial colonisation of the genital tract and subsequent preterm delivery and late miscarriage", BMJ, 308, pp.295~298 (1994)[DOI]
  5. Donati L, "Vaginal microbial flora and outcome of pregnancy", Arch Gynecol Obstet, 281, pp.589~600 (2010)[DOI]
  6. Donders GG, "Definition of a type of abnormal vaginal flora that is distinct from bacterial vaginosis: aerobic vaginitis", BJOG, 109, pp.34~43 (2002)[DOI]
  7. Romero R, "The role of infection in preterm labour and delivery", Paediatr Perinat Epidemiol, 15(Suppl 2), pp.41~56 (2001)[DOI]
  8. Donders G, "Abnormal vaginal flora in the first trimester, but not full-blown bacterial vaginosis, is associated with preterm birth", Prenat Neonatal Med, 3, pp.588~593 (1998)
  9. Donders GG, "Predictive value for preterm birth of abnormal vaginal flora, bacterial vaginosis and aerobic vaginitis during the first trimester of pregnancy", BJOG, 116, pp.1315~1324 (2009)[DOI]
  10. Huang YE, "Homogeneity of the vaginal microbiome at the cervix, posterior fornix, and vaginal canal in pregnant Chinese women", Microb Ecol, 69, pp.407~414 (2015)[DOI]
  11. Hawes SE, "Hydrogen peroxide-producing lactobacilli and acquisition of vaginal infections", J Infect Dis, 174, pp.1058~1063 (1996)[DOI]
  12. Romero R, "The vaginal microbiota of pregnant women who subsequently have spontaneous preterm labor and delivery and those with a normal delivery at term", Microbiome, 2, pp.18~ (2014)[DOI]
  13. Brzychczy-Wloch M, "Dynamics of colonization with group B streptococci in relation to normal flora in women during subsequent trimesters of pregnancy", New Microbiol, 37, pp.307~319 (2014)
  14. Waites KB, "Mycoplasmas and ureaplasmas as neonatal pathogens", Clin Microbiol Rev, 18, pp.757~789 (2005)[DOI]
  15. Donders G, "Aerobic vaginitis in pregnancy", BJOG, 118, pp.1163~1170 (2011)[DOI]
  16. Rezeberga D, "Placental histological inflammation and reproductive tract infections in a low risk pregnant population in Latvia", Acta Obstet Gynecol Scand, 87, pp.360~365 (2008)[DOI]
  17. Honda H, "The frequent shift to intermediate flora in preterm delivery cases after abnormal vaginal flora screening", Sci Rep, 4, pp.4799~ (2014)
  18. Schminkey DL, "Imitating a stress response: a new hypothesis about the innate immune system's role in pregnancy", Med Hypotheses, 82, pp.721~729 (2014)[DOI]
  19. Gargano JW, "Mid-pregnancy circulating cytokine levels, histologic chorioamnionitis and spontaneous preterm birth", J Reprod Immunol, 79, pp.100~110 (2008)[DOI]
  20. Catov JM, "Inflammation and dyslipidemia related to risk of spontaneous preterm birth", Am J Epidemiol, 166, pp.1312~1319 (2007)[DOI]
  21. Goldenberg RL, "Plasma ferritin and pregnancy outcome", Am J Obstet Gynecol, 175, pp.1356~1359 (1996)[DOI]
  22. Holzman C, "Association of maternal IgM concentrations above the median at 15-19 weeks of gestation and early preterm delivery", Lancet, 354, pp.1095~1096 (1999)[DOI]
  23. Brocklehurst P, "Antibiotics for treating bacterial vaginosis in pregnancy", Cochrane Database Syst Rev, pp.CD000262~ (2013)
  24. Lamont RF, "Treatment of abnormal vaginal flora in early pregnancy with clindamycin for the prevention of spontaneous preterm birth: a systematic review and metaanalysis", Am J Obstet Gynecol, 205, pp.177~190 (2011)[DOI]
  25. McDonald HM, "Changes in vaginal flora during pregnancy and association with preterm birth", J Infect Dis, 170, pp.724~728 (1994)[DOI]
  26. Carey JC, "Is a change in the vaginal flora associated with an increased risk of preterm birth", Am J Obstet Gynecol, 192, pp.1341~1346 (2005)[DOI]
  27. Boldenow E, "Group B streptococcus circumvents neutrophils and neutrophil extracellular traps during amniotic cavity invasion and preterm labor", Sci Immunol, 1, pp.eaah4576~ (2016)
  28. Shirazi M, "The prevalence of group B streptococcus colonization in Iranian pregnant women and its subsequent outcome", Int J Fertil Steril, 7, pp.267~270 (2014)
  29. Allen U, "Relationship between antenatal group B streptococcal vaginal colonization and premature labour", Paediatr Child Health, 4, pp.465~469 (1999)[DOI]
  30. Jeong H, "Comparison of changes in etiologic microorganisms causing early-onset neonatal sepsis between preterm labor and preterm premature rupture of membranes", J Matern Fetal Neonatal Med, 28, pp.1923~1928 (2015)[DOI]
  31. Sgro M, "Early-onset neonatal sepsis: rate and organism pattern between 2003 and 2008", J Perinatol, 31, pp.794~798 (2011)[DOI]
  32. Kim JY, "Abnormal vaginal colonization by gram-negative bacteria is significantly higher in pregnancy conceived through infertility treatment compared to natural pregnancy", J Matern Fetal Neonatal Med, 30, pp.556~561 (2017)[DOI]
  33. Krohn MA, "Vaginal colonization by Escherichia coli as a risk factor for very low birth weight delivery and other perinatal complications", J Infect Dis, 175, pp.606~610 (1997)[DOI]
  34. Committee on Practice Bulletins-Obstetrics, "Practice bulletin no. 130: prediction and prevention of preterm birth", Obstet Gynecol, 120, pp.964~973 (2012)[DOI]
  35. Morency AM, "The effect of second-trimester antibiotic therapy on the rate of preterm birth", J Obstet Gynaecol Can, 29, pp.35~44 (2007)[DOI]
  36. Lamont RF, "Intravaginal clindamycin to reduce preterm birth in women with abnormal genital tract flora", Obstet Gynecol, 101, pp.516~522 (2003)

관련 논문AI추천

The Prevalence of Vaginal Microorganisms in Pregnant Women with Preterm Labor and Preterm Birth어영, 박순덕, 이안나, 장인호, 최성진대한진단검사의학회 · Annals of Laboratory Medicine2012 · 제32권 제3호Vaginal Microbiota Profiles of Native Korean Women and Associations with High-Risk Pregnancy김병찬, 박경량, 신종오, 이문수, 이성기, 장동호, 조병관한국미생물·생명공학회 · Journal of Microbiology and Biotechnology2020 · 제30권 제2호Vaginal microbiome and its implications in preterm birthGain Lee, Suenie Park, Sunwha Park, Yoon-Young Go, Young-Ah You, Young Ju Kim, Young Min Hur대한산부인과학회 · Obstetrics & Gynecology Science2025 · 제68권 제6호Risk Factors for Group B Streptococcus Colonization Among Pregnant Women in Korea기모란, 김문영, 서용수, 오관영, Betsy Foxman, Eun Ju Kim, Jae-Hyug Yang, Jung-Hwan Shin, Young Rae Song한국역학회 · Epidemiology and Health2011 · 제33권 Prevalence of group B streptococcus colonization in pregnant women in a tertiary care center in Korea김기태, 김다현, 김영남, 민병진, 변정미, 성문수, 이경복, 정대훈, 정은정대한산부인과학회 · Obstetrics & Gynecology Science2018 · 제61권 제5호Usefulness of a Rapid Real-time PCR Assay in Prenatal Screening for Group B Streptococcus Colonization김영문, 김의종, 박성섭, 박정수, 성문우, 신손문, 양재혁, 조동희대한진단검사의학회 · Annals of Laboratory Medicine2013 · 제33권 제1호

이 간행물의 다른 논문 (11건)