The Role of Reproductive Tract Flora in Pregnancy

doi:10.12280/gjfckx.20230168

Abstract

Abstract:

There are many kinds of reproductive tract flora, which are symbiotic and antagonistic to each other. They play an important role in defending infection, promoting pregnancy and maintaining a normal intrauterine environment. The metabolites produced by the interaction between the reproductive tract flora and the host are not only related to flora imbalance and host immunity, but also related to adverse pregnancy outcomes. In recent years, the research on the correlation between the role of reproductive tract flora in pregnancy has gradually attracted the attention of the academic community. Therefore, this article attempts to explain the complex interaction between the reproductive tract flora and the host from the aspects of the role of vaginal and cervical flora, uterine cavity flora, fallopian tube and follicular fluid flora in normal pregnancy, as well as the correlation between common microorganisms in the reproductive tract and adverse pregnancy outcomes, in order to provide a basis for studying the mechanism and treatment of adverse pregnancy outcomes.

Key words: Microbiota, Reproductive tract infections, Genitalia, female, Pregnancy outcomes, Dysbacteriosis

MU Xin-dan, GUO Jie. The Role of Reproductive Tract Flora in Pregnancy[J]. Journal of International Obstetrics and Gynecology, 2023, 50(4): 416-420.

References 37

[1]	Wang W, Hao J, An R. Abnormal vaginal flora correlates with pregnancy outcomes: A retrospective study from 737 pregnant women[J]. Eur J Obstet Gynecol Reprod Biol, 2022, 272:64-68. doi: 10.1016/j.ejogrb.2022.03.013. doi: 10.1016/j.ejogrb.2022.03.013 pmid: 35286920
[2]	中华医学会妇产科学分会感染性疾病协作组. 细菌性阴道病诊治指南(2021修订版)[J]. 中华妇产科杂志, 2021, 56(1):3-6. doi: 10.3760/cma.j.cn112141-20200717-00583. doi: 10.3760/cma.j.cn112141-20200717-00583
[3]	Akieda-Asai S, Ma H, Date Y. Palmitic acid induces guanylin gene expression through the Toll-like receptor 4/nuclear factor-κB pathway in rat macrophages[J]. Am J Physiol Cell Physiol, 2019, 317(6):C1239-C1246. doi: 10.1152/ajpcell.00081.2019. doi: 10.1152/ajpcell.00081.2019
[4]	Olmos-Ortiz A, Déciga-García M, Preciado-Martínez E, et al. Prolactin decreases LPS-induced inflammatory cytokines by inhibiting TLR-4/NFκB signaling in the human placenta[J]. Mol Hum Reprod, 2019, 25(10):660-667. doi: 10.1093/molehr/gaz038. doi: 10.1093/molehr/gaz038 pmid: 31263869
[5]	廖秦平, 吴文湘. 女性阴道微生态评价体系的临床应用[J]. 中国妇产科临床杂志, 2010, 11(3):163-164. doi: 10.3969/j.issn.1672-1861.2010.03.001. doi: 10.3969/j.issn.1672-1861.2010.03.001
[6]	Chee W, Chew SY, Than L. Vaginal microbiota and the potential of Lactobacillus derivatives in maintaining vaginal health[J]. Microb Cell Fact, 2020, 19(1):203. doi: 10.1186/s12934-020-01464-4. doi: 10.1186/s12934-020-01464-4 pmid: 33160356
[7]	Chen C, Song X, Wei W, et al. The microbiota continuum along the female reproductive tract and its relation to uterine-related diseases[J]. Nat Commun, 2017, 8(1):875. doi: 10.1038/s41467-017-00901-0. doi: 10.1038/s41467-017-00901-0 pmid: 29042534
[8]	崔媛媛, 叶德盛, 郑炜炜, 等. 宫颈微生物菌群对IVF-ET妊娠结局的影响[J]. 生殖医学杂志, 2022, 31(12):1690-1698. doi: 10.3969/j.issn.1004-3845.2022.12.012. doi: 10.3969/j.issn.1004-3845.2022.12.012
[9]	Kyono K, Hashimoto T, Nagai Y, et al. Analysis of endometrial microbiota by 16S ribosomal RNA gene sequencing among infertile patients: a single-center pilot study[J]. Reprod Med Biol, 2018, 17(3):297-306. doi: 10.1002/rmb2.12105. doi: 10.1002/rmb2.12105 pmid: 30013432
[10]	Moreno I, Codoñer FM, Vilella F, et al. Evidence that the endometrial microbiota has an effect on implantation success or failure[J]. Am J Obstet Gynecol, 2016, 215(6):684-703. doi: 10.1016/j.ajog.2016.09.075. doi: S0002-9378(16)30782-7 pmid: 27717732
[11]	张明玮, 漆倩荣, 谢青贞. 宫腔微生物与女性生殖健康疾病的关系[J]. 国际生殖健康/计划生育杂志, 2022, 41(3):214-218. doi:10.12280/gjszjk.20220111. doi: 10.12280/gjszjk.20220111
[12]	蔺凯丽, 郭洁, 任姝晴, 等. 复发性流产患者生殖道菌群特征的初步研究[J]. 国际生殖健康/计划生育杂志, 2022, 41(3):177-183. doi:10.12280/gjszjk.20220153. doi: 10.12280/gjszjk.20220153
[13]	Wu YR, Dong YH, Liu CJ, et al. Microbiological composition of follicular fluid in patients undergoing IVF and its association with infertility[J]. Am J Reprod Immunol, 2023, 89(3):e13652. doi: 10.1111/aji.13652. doi: 10.1111/aji.13652
[14]	Owens CE, Daniels KM, Ealy AD, et al. Graduate Student Literature Review: Potential mechanisms of interaction between bacteria and the reproductive tract of dairy cattle[J]. J Dairy Sci, 2020, 103(11):10951-10960. doi: 10.3168/jds.2019-18050. doi: 10.3168/jds.2019-18050 pmid: 32896395
[15]	Pelzer ES, Allan JA, Waterhouse MA, et al. Microorganisms within human follicular fluid: effects on IVF[J]. PLoS One, 2013, 8(3):e59062. doi: 10.1371/journal.pone.0059062. doi: 10.1371/journal.pone.0059062
[16]	Wallace M, Cottell E, Gibney MJ, et al. An investigation into the relationship between the metabolic profile of follicular fluid, oocyte developmental potential, and implantation outcome[J]. Fertil Steril, 2012, 97(5):1078-1084.e1-8. doi: 10.1016/j.fertnstert.2012.01.122. doi: 10.1016/j.fertnstert.2012.01.122 pmid: 22365382
[17]	Pelzer ES, Willner D, Buttini M, et al. The fallopian tube microbiome: implications for reproductive health[J]. Oncotarget, 2018, 9(30):21541-21551. doi: 10.18632/oncotarget.25059. doi: 10.18632/oncotarget.25059 pmid: 29765558
[18]	Rice S, Christoforidis N, Gadd C, et al. Impaired insulin-dependent glucose metabolism in granulosa-lutein cells from anovulatory women with polycystic ovaries[J]. Hum Reprod, 2005, 20(2):373-381. doi: 10.1093/humrep/deh609. doi: 10.1093/humrep/deh609 pmid: 15539436
[19]	刘楼, 许涵洁, 陈道桢, 等. 阴道微生态在早产中的研究进展[J]. 中国微生态学杂志, 2020, 32(5):598-600. doi: 10.13381/j.cnki.cjm.202005023. doi: 10.13381/j.cnki.cjm.202005023
[20]	Sule-Odu AO, Akadri AA, Oluwole AA, et al. Vaginal Candida infection in pregnancy and its implications for fetal well-being[J]. Afr J Reprod Health, 2020, 24(3):33-40. doi: 10.29063/ajrh2020/v24i3.4. doi: 10.29063/ajrh2020/v24i3.4 pmid: 34077125
[21]	顾华妍, 张海燕, 王薇, 等. 自然流产前患者阴道微生态评价与诱病危险因素分析[J]. 中国妇产科临床杂志, 2020, 21(3):248-250. doi: 10.13390/j.issn.1672-1861.2020.03.009. doi: 10.13390/j.issn.1672-1861.2020.03.009
[22]	Hasperhoven GF, Al-Nasiry S, Bekker V, et al. Universal screening versus risk-based protocols for antibiotic prophylaxis during childbirth to prevent early-onset group B streptococcal disease: a systematic review and meta-analysis[J]. BJOG, 2020, 127(6):680-691. doi: 10.1111/1471-0528.16085. doi: 10.1111/1471-0528.16085
[23]	Lacey L, Daulton E, Wicaksono A, et al. Detection of Group B Streptococcus in pregnancy by vaginal volatile organic compound analysis: a prospective exploratory study[J]. Transl Res, 2020, 216:23-29. doi: 10.1016/j.trsl.2019.09.002. doi: S1931-5244(19)30209-9 pmid: 31585066
[24]	Ji Y, Zhao C, Ma XX, et al. Outcome of a screening program for the prevention of neonatal early-onset group B Streptococcus infection: a population-based cohort study in Inner Mongolia, China[J]. J Med Microbiol, 2019, 68(5):803-811. doi: 10.1099/jmm.0.000976. doi: 10.1099/jmm.0.000976 pmid: 30994439
[25]	关志炜, 徐天琪, 沈松, 等. 牙周炎促进不良妊娠结局的途径与作用机制[J]. 四川大学学报(医学版), 2023, 54(1):39-48. doi: 10.12182/20230160501. doi: 10.12182/20230160501
[26]	Doyle RM, Harris K, Kamiza S, et al. Bacterial communities found in placental tissues are associated with severe chorioamnionitis and adverse birth outcomes[J]. PLoS One, 2017, 12(7):e0180167. doi: 10.1371/journal.pone.0180167. doi: 10.1371/journal.pone.0180167
[27]	Fardini Y, Wang X, Témoin S, et al. Fusobacterium nucleatum adhesin FadA binds vascular endothelial cadherin and alters endothelial integrity[J]. Mol Microbiol, 2011, 82(6):1468-1480. doi: 10.1111/j.1365-2958.2011.07905.x. doi: 10.1111/j.1365-2958.2011.07905.x pmid: 22040113
[28]	Hazra A, Collison MW, Davis AM. CDC Sexually Transmitted Infections Treatment Guidelines, 2021[J]. JAMA, 2022, 327(9):870-871. doi: 10.1001/jama.2022.1246. doi: 10.1001/jama.2022.1246 pmid: 35230409
[29]	梅燕, 董良波, 陈丹. 宫颈癌患者感染乳头瘤病毒亚型和其他病原体感染检测及血清炎症因子水平分析[J]. 中国病原生物学杂志, 2018, 13(12):1405-1408. doi: 10.13350/j.cjpb.181225. doi: 10.13350/j.cjpb.181225
[30]	杨园园, 李婷, 阎晓丽, 等. 生殖道支原体感染与胎膜早破的关系及其对线粒体凋亡通路的影响[J]. 中华医院感染学杂志, 2023, 33(6):910-914. doi: 10.11816/cn.ni.2023-220727. doi: 10.11816/cn.ni.2023-220727
[31]	Theis KR, Romero R, Motomura K, et al. Microbial burden and inflammasome activation in amniotic fluid of patients with preterm prelabor rupture of membranes[J]. J Perinat Med, 2020, 48(2):115-131. doi: 10.1515/jpm-2019-0398. doi: 10.1515/jpm-2019-0398 pmid: 31927525
[32]	Matasariu DR, Ursache A, Agache A, et al. Genital infection with Ureaplasma urealyticum and its effect on pregnancy[J]. Exp Ther Med, 2022, 23(1):89. doi: 10.3892/etm.2021.11012. doi: 10.3892/etm.2021.11012 pmid: 34934454
[33]	林亚芬, 朱秋敏. 胎膜早破孕妇宫颈分泌物B族链球菌、支原体、衣原体感染状况及妊娠结局分析[J]. 中国妇幼保健, 2020, 35(5):817-819. doi: 10.19829/j.zgfybj.issn.1001-4411.2020.05.011. doi: 10.19829/j.zgfybj.issn.1001-4411.2020.05.011
[34]	廖燕, 张淑珍, 赵红艳, 等. 妊娠晚期HPV感染孕产妇阴道炎发生率及妊娠结局的影响分析[J]. 中华医院感染学杂志, 2017, 27(23):5460-5463. doi: 10.11816/cn.ni.2017-171727. doi: 10.11816/cn.ni.2017-171727
[35]	Gholizadeh O, Yekanipour Z, Kivi S, et al. Review of the evidence of the effects of human papillomavirus infection and Gardnerella vaginalis, and their co-infection on infertility[J]. Microb Pathog, 2023, 175:105980. doi: 10.1016/j.micpath.2023.105980. doi: 10.1016/j.micpath.2023.105980
[36]	李林江, 赵星, 孙少青, 等. 高危型HPV感染对IVF/ICSI-ET患者PBMCs中TLR4、NF-κB表达的影响[J]. 中华医院感染学杂志, 2022, 32(14):2174-2178. doi: 10.11816/cn.ni.2022-212237. doi: 10.11816/cn.ni.2022-212237
[37]	郭海春, 宋玉莹, 黄利辉, 等. 多种生殖道病原体感染协同人乳头瘤病毒感染对育龄女性胎膜早破风险影响[J]. 中国临床医生杂志, 2022, 50(11):1372-1375. doi: 10.3969/j.issn.2095-8552.2022.11.033. doi: 10.3969/j.issn.2095-8552.2022.11.033