"Transition of the genital mollicutes from the second to the third trimester of pregnancy and its association with adverse pregnancy outcomes in GDM women: a prospective, single-center cohort study from China"

作者全名："Xuan, Yan; Zhao, Jun; Hong, Xiang; Yan, Tao; Zhang, Yue; Zhou, Xu; Zhang, Junhui; Wang, Bei"

作者地址："[Xuan, Yan; Hong, Xiang; Yan, Tao; Zhou, Xu; Wang, Bei] Southeast Univ, Sch Publ Hlth, Dept Epidemiol & Stat, Minst Educ,Key Lab Environm Med & Engn, 87 Dingjiaqiao Rd, Nanjing, Jiangsu, Peoples R China; [Zhao, Jun; Zhang, Yue] Natl Res Inst Family Planning, Beijing, Peoples R China; [Zhao, Jun; Zhang, Yue] Natl Human Genet Resources Ctr, Beijing, Peoples R China; [Zhang, Junhui] Chongqing Med Univ, Affiliated Hosp 1, Hlth Management Ctr, Chongqing, Peoples R China"

通信作者："Wang, B (通讯作者)，Southeast Univ, Sch Publ Hlth, Dept Epidemiol & Stat, Minst Educ,Key Lab Environm Med & Engn, 87 Dingjiaqiao Rd, Nanjing, Jiangsu, Peoples R China.; Zhang, JH (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Hlth Management Ctr, Chongqing, Peoples R China."

来源：BMC PREGNANCY AND CHILDBIRTH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001197202100001

JCR分区：Q1

影响因子：2.8

年份：2024

卷号：24

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Gestational diabetes mellitus; Mollicutes; Ureaplasma urealyticum; Mycoplasma hominis; Adverse pregnancy outcomes

摘要："Background The association of genital Mollicutes infection transition with adverse pregnancy outcomes was insignificant among general pregnant women, but there remains a paucity of evidence linking this relationship in gestational diabetes mellitus (GDM) women. The aim was to investigate the association between genital Mollicutes infection and transition and adverse pregnancy outcomes in GDM women, and to explore whether this association still exist when Mollicutes load varied. Methods We involved pregnant women who attended antenatal care in Chongqing, China. After inclusion and exclusion criteria, we conducted a single-center cohort study of 432 GDM women with pregnancy outcomes from January 1, 2018 to December 31, 2021. The main outcome was adverse pregnancy outcomes, including premature rupture of membrane (PROM), fetal distress, macrosomia and others. The exposure was Mollicutes infection, including Ureaplasma urealyticum (Uu) and Mycoplasma hominis (Mh) collected in both the second and the third trimesters, and testing with polymerase chain reaction method. The logistic regression models were used to estimate the relationship between Mollicutes infection and adverse pregnancy outcomes. Results Among 432 GDM women, 241 (55.79%) were infected with genital Mollicutes in either the second or third trimester of pregnancy. At the end of the pregnancy follow-up, 158 (36.57%) participants had adverse pregnancy outcomes, in which PROM, fetal distress and macrosomia were the most commonly observed adverse outcomes. Compared with the uninfected group, the Mollicutes (+/-) group showed no statistical significant increase in PROM (OR = 1.05, 95% CI:0.51 similar to 2.08) and fetal distress (OR = 1.21, 95% CI: 0.31 similar to 3.91). Among the 77 participants who were both Uu positive in the second and third trimesters, 38 participants presented a declined Uu load and 39 presented an increased Uu load. The Uu increased group had a 2.95 odds ratio (95% CI: 1.10 similar to 8.44) for adverse pregnancy outcomes. Conclusion Mollicutes infection and transition during trimesters were not statistically associated with adverse pregnancy outcomes in GDM women. However, among those consistent infections, women with increasing Uu loads showed increased risks of adverse pregnancy outcomes. For GDM women with certain Mollicutes infection and colonization status, quantitative screening for vaginal infection at different weeks of pregnancy was recommended to provide personalized fertility treatment."

基金机构：National Natural Science Foundation of China

基金资助正文：We thank all the health workers and countless participants for their tremendous efforts and collaboration.