Relationship between Enolase Level and Pregnancy Outcome in Patients with Vulvovaginal Candidiasis during Pregnancy

doi:10.12280/gjfckx.20231013

Abstract

Abstract:

Objective: To investigate the relationship between enolase (Eno) content, vaginal microecology and pregnancy outcomes in patients with vulvovaginal candidiasis (VVC) during pregnancy. Methods: A retrospective study was conducted on 77 pregnant VVC patients who were hospitalized and delivered in the obstetrics department of the 980th Hospital of PLA Joint Logistics Support Forces from April 2021 to April 2022. The pregnancy outcomes of pregnant VVC patients were observed and statistically analyzed, and they were divided into 49 cases with adverse pregnancy outcomes and 28 cases with normal pregnancy outcomes. The general data, vaginal microecological indicators, (1,3)-β-D-glucan and Eno levels were compared between the two groups. Logistic regression was applied to analyze the influencing factors of adverse pregnancy outcomes in VVC patients during pregnancy. Receiver operating characteristic curve was applied to analyze the diagnostic value of (1,3)-β-D-glucan and Eno for adverse pregnancy outcomes in patients with VVC during pregnancy. Results: The proportion of patients treated with anti-infection treatment in the adverse pregnancy outcome group was lower than that in the normal pregnancy outcome group, and the difference was statistically significant ( χ²=4.270, P=0.039). The proportions of vaginal flora density of grade Ⅱ-Ⅲ, flora diversity of grade Ⅱ-Ⅲ, cleanliness of grade Ⅰ-Ⅱ, pH value 3.8-4.5, hydrogen peroxide positivity, and leukocyte esterase negativity in the adverse pregnancy outcome group were lower than those in the normal pregnancy outcome group, the differences were statistically significant (all P<0.05). The levels of (1,3)-β-D-glucan and Eno in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group, the differences were statistically significant (all P<0.001). (1,3)-β-D-glucan and Eno were independent risk factors for adverse pregnancy outcomes in patients with VVC during pregnancy (P<0.05), the vaginal flora density of grade Ⅱ-Ⅲ was protective factor (P<0.05). The AUC of (1,3)-β-D-glucan and Eno in the combined to diagnosis adverse pregnancy outcomes in patients with VVC during pregnancy was higher than that of a single index, with a sensitivity of 95.92% and a specificity of 82.14%. The combination of the two methods was better than that of (1,3)-β-D-glucan (Z=2.092, P=0.036) and Eno (Z=2.703, P=0.007). Conclusions: Elevated levels of (1,3)-β-D-glucan and Eno, and abnormalities in vaginal microecology can increase the risk of adverse pregnancy outcomes in VVC patients during pregnancy, and (1,3)-β-D-glucan combined with Eno can be used to screen the risk of adverse pregnancy outcomes in patients with VVC during pregnancy.

Key words: Pregnant women, Candidiasis, vulvovaginal, Phosphopyruvate hydratase, Candida, Pregnancy outcome

WANG Fang-fang, ZHAO Hui-hai, WU Yang, SUN Li. Relationship between Enolase Level and Pregnancy Outcome in Patients with Vulvovaginal Candidiasis during Pregnancy[J]. Journal of International Obstetrics and Gynecology, 2024, 51(4): 468-472.

Figures/Tables 6

References 22

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组别	n	年龄（岁）	孕周（周）	婚姻状况（已婚）	首次妊娠	文化程度（高中及以上）	不良妊娠史	居住地（农村）	妊娠期糖尿病	抗感染治疗
正常妊娠结局组	28	29.12±5.54	37.13±2.31	21（75.00）	19（67.86）	15（53.57）	2（7.14）	11（39.29）	7（25.00）	26（92.86）
不良妊娠结局组	49	28.81±5.77	37.72±2.25	42（85.71）	32（65.31）	23（46.94）	6（12.24）	27（55.10）	10（20.41）	36（73.47）
t或χ²		0.230	1.096	1.375	0.052	0.314	0.498	1.783	0.218	4.270
P		0.819	0.276	0.241	0.820	0.575	0.480	0.182	0.640	0.039

组别	n	年龄（岁）	孕周（周）	婚姻状况（已婚）	首次妊娠	文化程度（高中及以上）	不良妊娠史	居住地（农村）	妊娠期糖尿病	抗感染治疗
正常妊娠结局组	28	29.12±5.54	37.13±2.31	21（75.00）	19（67.86）	15（53.57）	2（7.14）	11（39.29）	7（25.00）	26（92.86）
不良妊娠结局组	49	28.81±5.77	37.72±2.25	42（85.71）	32（65.31）	23（46.94）	6（12.24）	27（55.10）	10（20.41）	36（73.47）
t或χ²		0.230	1.096	1.375	0.052	0.314	0.498	1.783	0.218	4.270
P		0.819	0.276	0.241	0.820	0.575	0.480	0.182	0.640	0.039

组别	n	阴道菌群密集度（Ⅱ~Ⅲ级）	阴道菌群多样性（Ⅱ~Ⅲ级）	清洁度（Ⅰ~Ⅱ度）	pH值3.8~4.5	过氧化氢阳性	白细胞酯酶阴性
正常妊娠结局组	28	13（46.43）	14（50.00）	18（64.29）	22（78.57）	19（67.86）	17（60.71）
不良妊娠结局组	49	7（14.29）	10（20.41）	13（26.53）	12（24.49）	16（32.65）	14（28.57）
χ²		9.574	7.273	10.560	21.135	8.907	7.654
P		0.002	0.007	0.001	<0.001	0.003	0.006

组别	n	阴道菌群密集度（Ⅱ~Ⅲ级）	阴道菌群多样性（Ⅱ~Ⅲ级）	清洁度（Ⅰ~Ⅱ度）	pH值3.8~4.5	过氧化氢阳性	白细胞酯酶阴性
正常妊娠结局组	28	13（46.43）	14（50.00）	18（64.29）	22（78.57）	19（67.86）	17（60.71）
不良妊娠结局组	49	7（14.29）	10（20.41）	13（26.53）	12（24.49）	16（32.65）	14（28.57）
χ²		9.574	7.273	10.560	21.135	8.907	7.654
P		0.002	0.007	0.001	<0.001	0.003	0.006

组别	n	(1,3)-β-D-葡聚糖（pg/mL）	Eno（μg/mL）
正常妊娠结局组	28	104.35±31.59	0.25±0.08
不良妊娠结局组	49	226.51±73.42	0.57±0.18
t		8.355	8.899
P		<0.001	<0.001