Composition and Stability of Vaginal Microbiota During Labor and Postpartum

分娩期间和产后阴道微生物群的组成和稳定性

• 批准号: 8718743
• 负责人: Kathleen McElroy
• 金额: $ 3.63万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-15 至 2016-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8718743
• 关键词: Address; Admission activity; Affect; Age; Bacteria; Birth; Cervical Dilatations; Child; Childhood Asthma; Clinical; Collection; Cross-Sectional Studies; Data; Data Analyses; Discipline of obstetrics; Disease; Ensure; Environmental Exposure; Ethnic Origin; Exposure to; Feasibility Studies; Future; Health; Health Personnel; Healthcare; Hospitals; Hour; Hypersensitivity; Infection; Intervention Studies; Knowledge; Lactic acid; Lactobacillus; Lead; Linear Regressions; Link; Longitudinal Studies; Lubricants; Maternal and Child Health; Microbe; Mission; Modeling; Molecular; Mothers; Neonatal; Outcome; Pharmaceutical Preparations; Play; Postpartum Period; Predisposition; Pregnancy; Pregnancy Outcome; Pregnant Women; Process; Proxy; Recruitment Activity; Research; Respiratory distress; Risk; Role; Sampling; Severities; Sexually Transmitted Diseases; Smoking Status; Swab; Techniques; Testing; Time; Translating; Vagina; Woman; Women' s Health; World Health Organization; adverse outcome; aged; base; clinical practice; cohort; experience; improved; intrapartum; microbial; microbial community; microbiome; neonate; novel; prevent; programs; public health relevance; rRNA Genes; reproductive; response; sample collection; success

DESCRIPTION (provided by applicant): The composition and stability of vaginal microbiota have critical implications for the health of women and children. Disruptions in the composition of the vaginal microbiota leading to increased pH and decreased Lactobacilli abundance and diversity, called dysbiosis, occur in over 29% of reproductive-aged women and are associated with severe reproductive tract sequelae including postpartum infection, adverse outcomes in future pregnancies and increased susceptibility to sexually transmitted infections. Moreover, neonates begin to form the basis of their own microbiome during birth and suboptimal colonization can lead to short and long-term health problems, such as respiratory distress at birth and childhood asthma and allergies. Factors leading to dysbiosis include the use of vaginal lubricants. Components in lubricants have the potential to alter the composition of vaginal microbiota. The relationship between dysbiosis and vaginal lubricants is concerning because lubricants are often used by healthcare practitioners to perform intrapartum vaginal exams. Previous studies and feasibility testing for this proposal show that women receive many exams during labor, suggesting that lubricant exposure occurs frequently during the labor process. However, no studies have examined the vaginal microbiota during labor. This study aims to characterize the composition and changes in the vaginal microbiota during labor, with a focus on effects from lubricants used during vaginal exams. A cohort of 50 low-risk primigravid women will be recruited and followed for approximately 12 weeks. Mid-vaginal swabs and vaginal pH samples will be collected before labor (36 weeks gestation), at 2 points during labor and at 6-8 weeks postpartum. Molecular-based techniques will be used to identify the dominant species of microbes at each time point. A chart review will allow for the collection of clinical birth data, including number of vaginal exams performed during labor. Multiple linear regression and linear mixed models will be used to analyze changes in proportions of dominant microbial species over time, particularly as related to the number of vaginal exams received during labor. Other potential predictors include ethnicity, age, medication use, smoking status and clinical labor factors. Findings have the potential to translate into safer obstetrical practices and improved maternal and child health.

描述（由申请人提供）：阴道菌群的组成和稳定性对妇女和儿童的健康具有关键意义。阴道菌群组成的干扰导致pH值增加并减少乳酸菌的丰度和多样性（称为营养不良）发生在29％以上的生殖老年妇女中，并且与包括产后感染在内的严重生殖性疫苗相关，包括产后感染，未来的妊娠不良症状，对性交的不良症状以及性交的耐受性增长。此外，新生儿在出生过程中开始构成自己的微生物组的基础，次优殖民可以导致短期和长期的健康问题，例如出生和儿童期哮喘和过敏时的呼吸窘迫。导致营养不良的因素包括使用阴道润滑剂。润滑剂中的成分有可能改变阴道菌群的组成。营养不良与阴道润滑剂之间的关系是关于医疗保健从业者经常使用润滑剂进行阴道内阴道检查的。该提案的先前研究和可行性测试表明，妇女在分娩过程中接受了许多检查，这表明润滑剂暴露在劳动过程中经常发生。但是，尚无研究在分娩过程中检查阴道菌群。这项研究旨在表征分娩过程中阴道菌群的组成和变化，重点是阴道检查过程中使用的润滑剂的作用。将招募50名低风险原始妇女的队列，并遵循大约12周。在分娩前（妊娠36周），分娩期间的2分和产后6-8周，将收集体阴道拭子和阴道pH样品。基于分子的技术将用于在每个时间点识别微生物的主要物种。图表审查将允许收集临床出生数据，包括在劳动期间进行的阴道检查数量。多种线性回归和线性混合模型将用于分析随着时间的流逝，占主导地位微生物物种比例的变化，尤其是与劳动期间接受的阴道检查的数量有关。其他潜在的预测因素包括种族，年龄，药物使用，吸烟状况和临床劳动因素。调查结果有可能转化为更安全的产科实践，并改善了产妇和儿童健康。