Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes
Abstract Introduction Our objective was to compare the vaginal microbiome in low‐risk and high‐risk pregnant women and to explore a potential association between vaginal microbiome and preterm birth. Material and methods A pilot, consecutive, longitudinal, multicenter study was conducted in pregnant...
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Wiley
2022-12-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.14460 |
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| author | Mireia Vargas Francisca Yañez Andrea Elias Andrea Bernabeu Maria Goya Zixuan Xie Alba Farrás Olga Sánchez Zaida Soler Carlos Blasquez Leonor Valle Anna Olivella Begoña Muñoz Maia Brik Elena Carreras Chaysavanh Manichanh |
| author_facet | Mireia Vargas Francisca Yañez Andrea Elias Andrea Bernabeu Maria Goya Zixuan Xie Alba Farrás Olga Sánchez Zaida Soler Carlos Blasquez Leonor Valle Anna Olivella Begoña Muñoz Maia Brik Elena Carreras Chaysavanh Manichanh |
| author_sort | Mireia Vargas |
| collection | DOAJ |
| description | Abstract Introduction Our objective was to compare the vaginal microbiome in low‐risk and high‐risk pregnant women and to explore a potential association between vaginal microbiome and preterm birth. Material and methods A pilot, consecutive, longitudinal, multicenter study was conducted in pregnant women at 18–22 weeks of gestation. Participants were assigned to one of three groups: control (normal cervix), pessary (cervical length ≤25 mm) and cerclage (cervical length ≤25 mm or history of preterm birth). Analysis and comparison of vaginal microbiota as a primary outcome was performed at inclusion and at 30 weeks of gestation, along with a follow‐up of pregnancy and perinatal outcomes. We assessed the vaginal microbiome of pregnant women presenting a short cervix with that of pregnant women having a normal cervix, and compared the vaginal microbiome of women with a short cervix before and after placement of a cervical pessary or a cervical cerclage. Results The microbiome of our control cohort was dominated by Lactobacillus crispatus and inners. Five community state types were identified and microbiome diversity did not change significantly over 10 weeks in controls. On the other hand, a short cervix was associated with a lower microbial load and higher microbial richness, and was not correlated with Lactobacillus relative abundance. After intervention, the cerclage group (n = 19) had a significant increase in microbial richness and a shift towards community state types driven by various bacterial species, including Lactobacillus mulieris, unidentified Bifidobacterium or Enterococcus. These changes were not significantly observed in the pessary (n = 26) and control (n = 35) groups. The cerclage group had more threatened preterm labor episodes and poorer outcomes than the control and pessary groups. Conclusions These findings indicate that a short cervix is associated with an altered vaginal microbiome community structure. The use of a cerclage for preterm birth prevention, as compared with a pessary, was associated with a microbial community harboring a relatively low abundance of Lactobacillus, with more threatened preterm labor episodes, and with poorer clinical outcomes. |
| format | Article |
| id | doaj-art-ae16cd9d02d548b9a9159e62b8ddbd79 |
| institution | DOAJ |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-ae16cd9d02d548b9a9159e62b8ddbd792025-08-20T03:22:12ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122022-12-01101121403141310.1111/aogs.14460Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changesMireia Vargas0Francisca Yañez1Andrea Elias2Andrea Bernabeu3Maria Goya4Zixuan Xie5Alba Farrás6Olga Sánchez7Zaida Soler8Carlos Blasquez9Leonor Valle10Anna Olivella11Begoña Muñoz12Maia Brik13Elena Carreras14Chaysavanh Manichanh15Department of Obstetrics, Maternal‐Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona Barcelona SpainMaternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III Madrid SpainMaternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III Madrid SpainDepartment of Obstetrics, Maternal‐Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona Barcelona SpainDepartment of Obstetrics, Maternal‐Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona Barcelona SpainMaternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III Madrid SpainDepartment of Obstetrics, Maternal‐Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona Barcelona SpainMicrobiome Lab Hospital Universitario Vall d'Hebron; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD); Department of Medicine, Universitat Autònoma de Barcelona Cerdanyola del Vallès SpainMaternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III Madrid SpainMaternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III Madrid SpainMaternal‐Fetal Medicine Unit, Department of Obstetrics Hospital Universitario Materno‐Infantil de Canarias Las Palmas de Gran Canaria SpainDepartment of Obstetrics Hospital de Sant Pau Barcelona SpainDepartment of Obstetrics and Gynecology Hospital Universitari Sant Joan de Reus Reus SpainDepartment of Obstetrics Hospital Universitario de Torrejón, Universidad Francisco de Vitoria Madrid SpainDepartment of Obstetrics, Maternal‐Fetal Medicine Unit Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona Barcelona SpainMaternal and Child Health and Development Network (SAMID) Instituto de Salud Carlos III Madrid SpainAbstract Introduction Our objective was to compare the vaginal microbiome in low‐risk and high‐risk pregnant women and to explore a potential association between vaginal microbiome and preterm birth. Material and methods A pilot, consecutive, longitudinal, multicenter study was conducted in pregnant women at 18–22 weeks of gestation. Participants were assigned to one of three groups: control (normal cervix), pessary (cervical length ≤25 mm) and cerclage (cervical length ≤25 mm or history of preterm birth). Analysis and comparison of vaginal microbiota as a primary outcome was performed at inclusion and at 30 weeks of gestation, along with a follow‐up of pregnancy and perinatal outcomes. We assessed the vaginal microbiome of pregnant women presenting a short cervix with that of pregnant women having a normal cervix, and compared the vaginal microbiome of women with a short cervix before and after placement of a cervical pessary or a cervical cerclage. Results The microbiome of our control cohort was dominated by Lactobacillus crispatus and inners. Five community state types were identified and microbiome diversity did not change significantly over 10 weeks in controls. On the other hand, a short cervix was associated with a lower microbial load and higher microbial richness, and was not correlated with Lactobacillus relative abundance. After intervention, the cerclage group (n = 19) had a significant increase in microbial richness and a shift towards community state types driven by various bacterial species, including Lactobacillus mulieris, unidentified Bifidobacterium or Enterococcus. These changes were not significantly observed in the pessary (n = 26) and control (n = 35) groups. The cerclage group had more threatened preterm labor episodes and poorer outcomes than the control and pessary groups. Conclusions These findings indicate that a short cervix is associated with an altered vaginal microbiome community structure. The use of a cerclage for preterm birth prevention, as compared with a pessary, was associated with a microbial community harboring a relatively low abundance of Lactobacillus, with more threatened preterm labor episodes, and with poorer clinical outcomes.https://doi.org/10.1111/aogs.1446016S rRNA genecerclagecervical lengthcommunity state typemicrobial communitymicrobial diversity |
| spellingShingle | Mireia Vargas Francisca Yañez Andrea Elias Andrea Bernabeu Maria Goya Zixuan Xie Alba Farrás Olga Sánchez Zaida Soler Carlos Blasquez Leonor Valle Anna Olivella Begoña Muñoz Maia Brik Elena Carreras Chaysavanh Manichanh Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes Acta Obstetricia et Gynecologica Scandinavica 16S rRNA gene cerclage cervical length community state type microbial community microbial diversity |
| title | Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes |
| title_full | Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes |
| title_fullStr | Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes |
| title_full_unstemmed | Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes |
| title_short | Cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes |
| title_sort | cervical pessary and cerclage placement for preterm birth prevention and cervicovaginal microbiome changes |
| topic | 16S rRNA gene cerclage cervical length community state type microbial community microbial diversity |
| url | https://doi.org/10.1111/aogs.14460 |
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