基于阴道乳酸菌的相对丰度和微生态特征的多变量模型的预测价值在怀孕24周和分娩前的自发早产:一个前性队列研究
SiLing Ren1, Qingrong Wu2, TingTing Li3
1Department of Obstetrics, Chongqing Fuling District Maternal and Child Health Hospital. Fuling District, Chongqing, China.
PloS one
|February 10, 2026
概括
怀孕24周时阴道乳杆菌相对丰度 (LRA) 的降低是自发早产 (sPTB) 的重要预测因素. 早期评估阴道微生物组和临床因素可以识别高风险怀孕.
科学领域:
- 生殖健康 生殖健康
- 微生物组研究 微生物组研究
- 产科 产科 产科 产科 产科
背景情况:
- 阴道微生态不平衡,特别是乳酸菌的低占主导地位,是自发早产 (sPTB) 的关键风险因素.
- 阴道微生物组组成和炎症标志物的预测价值在sPTB的妊娠阶段需要进一步澄清.
- 这项研究研究了阴道微生态在怀孕24周和分娩前对sPTB的预测潜力.
研究的目的:
- 评估阴道微生态在怀孕24周对自发早产的预测能力.
- 评估自发早产产产前阴道微生态的预测价值.
- 确定关键的阴道生物标志物和与自发早产风险相关的临床因素.
主要方法:
- 未来的多中心队列研究设计.
- 在怀孕24周和分娩前收集的阴道拭子.
- 分析包括乳酸菌相对丰富度 (LRA),病原体殖民和生物化学标记 (pH,过氧化,白细胞雌激酶, sialidase).
- 统计方法:多变量逻辑回归,ROC曲线和卡普兰-梅尔生存分析.
主要成果:
- 在24周,早产组的LRA较低,Amsel (AV) 和Nugent分数较高,阴道pH值升高.
- 增加的LRA显示与sPTB (OR=0.97) 有负相关性,而更高的平价率和早产史增加了风险.
- 独立的sPTB风险因素包括平价,先前的早产史,阴道pH>4.5,以及GBS阳性 (AUC=0.775).
- 在24周和分娩前较高的LRA水平与按期分娩的概率增加相关.
结论:
- 在怀孕24周减少的阴道LRA是自发早产的独立预测因素.
- 早期评估阴道微生物组,以及临床特征,有助于识别高风险怀孕.
- 将微生物组数据与临床因素相结合,可以通过及时干预来改善妊娠结果.
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