نقش گاردنرلا واژینالیس، آتوپوبیوم واژینه و موبیلونکوس در ایجاد زایمان زودرس؛ یک مطالعه مورد- شاهدی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد میکروبیولوژی، مرکز تحقیقات علوم آزمایشگاهی، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

2 دانشیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

3 کارشناس ارشد ایمنی‌شناسی، مرکز تحقیقات علوم آزمایشگاهی، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

4 کارشناس ارشد آمار، دانشکده پزشکی، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

5 دانشیار گروه آمار زیستی، مرکز تحقیقات مدیریت سلامت و توسعه اجتماعی، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

6 استاد گروه باکتری‌شناسی پزشکی، مرکز تحقیقات علوم آزمایشگاهی، دانشگاه علوم پزشکی گلستان، گرگان، ایران.

چکیده

مقدمه: زایمان زودرس، یکی از علل اصلی مرگ‌و‌میر در نوزادان و کودکان زیر 5 سال می ­باشد. علل زایمان زودرس به‌درستی شناسایی نشده است، اما می­توان به عفونت ­های باکتریایی مانند واژینوز باکتریایی اشاره کرد که در میان زنان باردار بسیار شایع می ­باشد. مطالعه حاضر با هدف تعیین نقش باکتری ­های مرتبط با واژینوز باکتریایی در ایجاد زایمان زودرس انجام شد.
روش‌کار: این مطالعه مورد- شاهدی در سال 94-1393 بر روی 100 زن با زایمان زودرس و 100 زن با زایمان به‌موقع در بیمارستان آموزشی- درمانی شهید صیاد شیرازی گرگان انجام شد. استخراج DNA از نمونه­ های واژینال انجام شده و با استفاده از پرایمرهای اختصاصی برای باکتری­ های آتوپوبیوم واژینه، گاردنرلا واژینالیس و جنس موبیلونکوس، PCR انجام شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 16) و آزمون کای اسکوئر و رگرسیون لوجستیک انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد..
یافته­ ها: فراوانی گاردنرلا، آتوپوبیوم و موبیلونکوس در گروه زایمان به‌موقع به‌ترتیب برابر 86%، 15% و 25% و در گروه زایمان زودرس به‌ترتیب 74%، 14% و 45% بود. توزیع موبیلونکوس در دو گروه زایمان زودرس و به‌موقع، از نظر آماری ارتباط معنی‌داری داشت (003/0=p). نسبت شانس زایمان زودرس در افرادی که از نظر موبیلونکوس مثبت بودند، 46/2 برابر ( فاصله اطمینان 95% 47/4-35/1) افرادی بود که از نظر موبیلونکوس منفی بودند.
نتیجه ­گیری: بر اساس نتایج این مطالعه، نسبت شانس زایمان زودرس با حضور موبیلونکوس در واژن افزایش معناداری داشت. بهتر است روش ­هایی برای تشخیص سریع این باکتری و در نتیجه پیشگیری از زایمان زودرس مدنظر قرار گیرد.

کلیدواژه‌ها

عنوان مقاله [English]

The role of Gardnerella vaginalis, Autopobium vaginae and Mobiloncus spp in preterm delivery: A case-control study

نویسندگان [English]

  • Sedigheh Livani 1
  • Sepideh Bakhshandeh Nosrat 2
  • Mahdiheh Naghavi Alhosseini 3
  • Amene Sadat Sheykholeslami 4
  • Mohammad Ali Vakili 5
  • Ezzat Allah Ghaemi 6
1 M.Sc. in Microbiology, Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
2 Associate professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
3 M.Sc. in Immunology, Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
4 M.Sc. in Statistics, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
5 Associate Professor, Department of Biostatistics, Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
6 Professor, Department of Medical Bacteriology, Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
چکیده [English]

Introduction: Preterm delivery is one of the leading causes of death in infants and children under 5 years of age. The causes of preterm delivery have not been properly identified, but some causes include infections such as bacterial vaginosis, which are very common among pregnant women. The present study was performed with aim to determine the role of bacteria associated with bacterial vaginosis in causing preterm delivery.
Methods: This case-control study was conducted in 2014-2015 on 100 women with term delivery and 100 women with preterm delivery in Shaheed Sayyad Shirazi hospital in Gorgan. DNA was extracted from vaginal samples and PCR was performed using specific primers for Atopobium vaginae, Gardnerella vaginalis and Mobiloncus spp. The data were analyzed using SPSS software (version 16) and Chi-square test and logistic regression. P<0.05 was considered statistically significant.
Results: Frequency of Gardnerella, Atopobium and Mobiluncus in term delivery were 86%, 15% and 25%, respectively and in preterm delivery were 74%, 14%, and 45%, respectively.  The distribution of Mobiloncus in the two groups of preterm and term delivery had a statistically significant relationship (P=0.003). The odds ratio (OR) of preterm delivery in women who were positive for Mobiloncus was 2.46 times (95% confidence interval 1.35-4.47) compared to those who were negative for Mobiloncus.
Conclusion: According to the findings of this study, the odds ratio of preterm delivery was significantly increased with the presence of Mobiloncus in the vagina. It is better to consider the methods to quickly detect this bacterium and thus prevent preterm delivery.

کلیدواژه‌ها [English]

  • Autopobium
  • Gardnerella
  • Mobiloncus
  • Preterm delivery

مراجع

  1. Chawanpaiboon S, Vogel JP, Moller AB, Lumbiganon P, Petzold M, Hogan D, et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. The Lancet global health 2019; 7(1):e37-46.
  2. Frey HA, Klebanoff MA. The epidemiology, etiology, and costs of preterm birth. InSeminars in fetal and neonatal medicine 2016; 21(2):68-73.
  3. Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional, and national causes of under-5 mortality in 2000–15: an updated systematic analysis with implications for the Sustainable Development Goals. The Lancet 2016; 388(10063):3027-35.
  4. Vakilian K, Ranjbaran M, Khorsandi M, Sharafkhani N, Khodadost M. Prevalence of preterm labor in Iran: A systematic review and meta-analysis. International Journal of Reproductive BioMedicine 2015; 13(12):743.
  5. Goldenberg RL, Culhane JF, Iams JD, Romero R. Epidemiology and causes of preterm birth. The lancet 2008; 371(9606):75-84.
  6. Nadeau HC, Subramaniam A, Andrews WW, editors. Infection and preterm birth. Seminars in Fetal and Neonatal Medicine; 2016: Elsevier.
  7. Daskalakis G, Psarris A, Koutras A, Fasoulakis Z, Prokopakis I, Varthaliti A, et al. Maternal Infection and Preterm Birth: From Molecular Basis to Clinical Implications. Children 2023;10(5):907.
  8. Golshani M, Eslami G, Goudarzi H, Soleymani RA, Fayaz F, Mohammadzadeh GS, et al. Detection of Chlamydia trachomatis, Mycoplasma hominis and Ureaplasma urealyticum by multiplex PCR in semen sample of infertile men. Iranian Journal of Public Health 2007; 36(2):50-7.
  9. Zozaya-Hinchliffe M, Lillis R, Martin DH, Ferris MJ. Quantitative PCR assessments of bacterial species in women with and without bacterial vaginosis. Journal of clinical microbiology 2010; 48(5):1812-9.
  10. Pépin J, Deslandes S, Giroux G, Sobéla F, Khonde N, Diakité S, et al. The complex vaginal flora of West African women with bacterial vaginosis. PLoS One 2011; 6(9):e25082.
  11. Tiveljung A, Forsum U, Monstein HJ. Classification of the genus Mobiluncus based on comparative partial 16S rRNA gene analysis. International Journal of Systematic and Evolutionary Microbiology 1996; 46(1):332-6.
  12. Nkembe NM, Kamga HG, Baiye WA, Chafa AB, Njotang PN. Streptococcus agalactiae prevalence and antimicrobial susceptibility pattern in vaginal and anorectal swabs of pregnant women at a tertiary hospital in Cameroon. BMC research notes 2018; 11:1-6.
  13. Nelson DB, Hanlon A, Nachamkin I, Haggerty C, Mastrogiannis DS, Liu C, et al. Early pregnancy changes in bacterial vaginosis‐associated bacteria and preterm delivery. Paediatric and perinatal epidemiology 2014; 28(2):88-96.
  14. Menard JP, Mazouni C, Salem-Cherif I, Fenollar F, Raoult D, Boubli L, et al. High vaginal concentrations of Atopobium vaginae and Gardnerella vaginalis in women undergoing preterm labor. Obstetrics & Gynecology 2010; 115(1):134-40.
  15. Bahar H, Torun MM, Öçer F, Kocazeybek B. Mobiluncus species in gynaecological and obstetric infections: antimicrobial resistance and prevalence in a Turkish population. International journal of antimicrobial agents 2005; 25(3):268-71.
  16. Vodstrcil LA, Twin J, Garland SM, Fairley CK, Hocking JS, Law MG, et al. The influence of sexual activity on the vaginal microbiota and Gardnerella vaginalis clade diversity in young women. PloS one 2017; 12(2):e0171856.
  17. Kamga YM, Ngunde JP, Akoachere JF. Prevalence of bacterial vaginosis and associated risk factors in pregnant women receiving antenatal care at the Kumba Health District (KHD), Cameroon. BMC pregnancy and childbirth 2019; 19(1):1-8.
  18. Mohammed RA, Elmukashfi ST, Khalifa OA, Eltaib HA. Detection of Vaginosis causing by Gardnerella vaginalis among Pregnant Women attending a Khartoum State Hospitals by using conversional method. Journal of Drug Delivery and Therapeutics 2019; 9(3):384-7.
  19. Arries C, Ferrieri P. Mobiluncus curtisii bacteremia: case study and literature review. Infectious Disease Reports 2022; 14(1):82-7.
  20. Dude CM, Saylany A, Brown A, Elovitz M, Anton L. Microbial supernatants from Mobiluncus mulieris, a bacteria strongly associated with spontaneous preterm birth, disrupts the cervical epithelial barrier through inflammatory and miRNA mediated mechanisms. Anaerobe 2020; 61:102127.
  21. Freitas AC, Bocking A, Hill JE, Money DM. Increased richness and diversity of the vaginal microbiota and spontaneous preterm birth. Microbiome 2018; 6(1):1-5.
  22. Dunlop AL, Satten GA, Hu YJ, Knight AK, Hill CC, Wright ML, et al. Vaginal microbiome composition in early pregnancy and risk of spontaneous preterm and early term birth among African American women. Frontiers in cellular and infection microbiology 2021; 11:641005.
  23. Romero R, Tarca A, Gomez-Lopez N, Winters A, Panzer J, Lin H, et al. The Vaginal Microbiota in Early Pregnancy Identifies a Subset of Women at Risk for Early Preterm Prelabor Rupture of Membranes and Preterm Birth. Research Square; 2022.
  24. Elovitz MA, Gajer P, Riis V, Brown AG, Humphrys MS, Holm JB, et al. Cervicovaginal microbiota and local immune response modulate the risk of spontaneous preterm delivery. Nature communications 2019; 10(1):1305.
  25. Hočevar K, Maver A, Vidmar Šimic M, Hodžić A, Haslberger A, Premru Seršen T, et al. Vaginal microbiome signature is associated with spontaneous preterm delivery. Frontiers in medicine 2019; 6:201.
  26. Joseph A, Lewis EL, Ferguson B, Guan Y, Anton L, Elovitz MA. Intrauterine colonization with Gardnerella vaginalis and Mobiluncus mulieris induces maternal inflammation but not preterm birth in a mouse model. American Journal of Reproductive Immunology 2023; 90(2):e13749.
  27. Shimaoka M, Yo Y, Doh K, Kotani Y, Suzuki A, Tsuji I, et al. Association between preterm delivery and bacterial vaginosis with or without treatment. Scientific reports 2019; 9(1):509.
  28. Bretelle F, Loubière S, Desbriere R, Loundou A, Blanc J, Heckenroth H, et al. Effectiveness and Costs of Molecular Screening and Treatment for Bacterial Vaginosis to Prevent Preterm Birth: The AuTop Randomized Clinical Trial. JAMA pediatrics 2023.
  29. Bretelle F, Rozenberg P, Pascal A, Favre R, Bohec C, Loundou A, et al. High Atopobium vaginae and Gardnerella vaginalis vaginal loads are associated with preterm birth. Clinical Infectious Diseases 2015; 60(6):860-7.
  30. Soltani M, Tabatabaee HR, Saeidinejat S, Eslahi M, Yaghoobi H, Mazloumi E, et al. Assessing the risk factors before pregnancy of preterm births in Iran: a population-based case-control study. BMC pregnancy and childbirth 2019; 19:1-8.
  31. Yang S, Reid G, Challis JR, Kim SO, Gloor GB, Bocking AD. Is there a role for probiotics in the prevention of preterm birth?. Frontiers in Immunology 2015; 6:62.
  32. Schaaf JM, Liem SM, Mol BW, Abu-Hanna A, Ravelli AC. Ethnic and racial disparities in the risk of preterm birth: a systematic review and meta-analysis. American journal of perinatology 2012: 433-50.
  33. Tabatabaei N, Eren AM, Barreiro LB, Yotova V, Dumaine A, Allard C, et al. Vaginal microbiome in early pregnancy and subsequent risk of spontaneous preterm birth: a case–control study. BJOG: An International Journal of Obstetrics & Gynaecology 2019; 126(3):349-58.
مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 6
شهریور 1402
صفحه 50-59

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