Prospective observational study of vaginal microbiota pre- and post-rescue cervical cerclage

Study information

Needs review

study design

case-control

Citation

PMID PubMed identifier for scientific articles.

30854760

DOI Digital object identifier for electronic documents.

10.1111/1471-0528.15600

URI

Authors

Brown RG, Chan D, Terzidou V, Lee YS, Smith A, Marchesi JR, MacIntyre DA, Bennett PR

Journal

BJOG : an international journal of obstetrics and gynaecology

Year

2019

Keywords:

Infection, preterm birth, rescue cerclage, vaginal microbiome

OBJECTIVE: To investigate the relation between vaginal microbiota composition and outcome of rescue cervical cerclage. DESIGN: Prospective observational study. SETTING: Queen Charlotte's and Chelsea Hospital, London. POPULATION: Twenty singleton pregnancies undergoing a rescue cervical cerclage. METHODS: Vaginal microbiota composition was analysed in women presenting with a dilated cervix and exposed fetal membranes before and 10 days following rescue cervical cerclage and was correlated with clinical outcomes. MAIN OUTCOME MEASURES: Composition of vaginal bacteria was characterised by culture-independent next generation sequencing. Successful cerclage was defined as that resulting in the birth of a neonate discharged from hospital without morbidity. Unsuccessful cerclage was defined as procedures culminating in miscarriage, intrauterine death, neonatal death or significant neonatal morbidity. RESULTS: Reduced Lactobacillus spp. relative abundance was observed in 40% of cases prior to rescue cerclage compared with 10% of gestation age-matched controls (8/20, 40% versus 3/30, 10%, P = 0.017). Gardnerella vaginalis was over-represented in women presenting with symptoms (3/7, 43% versus 0/13, 0%, P = 0.03, linear discriminant analysis, LDA (log 10) and cases culminating in miscarriage (3/6, 50% versus 0/14, 0%, P = 0.017). In the majority of cases (10/14, 71%) bacterial composition was unchanged following cerclage insertion and perioperative interventions. CONCLUSIONS: Reduced relative abundance of Lactobacillus spp. is associated with premature cervical dilation, whereas high levels of G. vaginalis are associated with unsuccessful rescue cerclage cases. The insertion of a rescue cerclage does not affect the underlying bacterial composition in the majority of cases. TWEETABLE ABSTRACT: Preterm cervical dilatation associates with reduced Lactobacillus spp. Presence of Gardnerella vaginalis predicts rescue cerclage failure.

Experiment 1

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Curated date: 2021/01/10

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Subjects

Location of subjects: United Kingdom

Host species Species from which microbiome was sampled. Contact us to have more species added.: Homo sapiens

Body site Anatomical site where microbial samples were extracted from according to the Uber Anatomy Ontology: Vagina Vagina,vagina,Distal oviductal region,Distal portion of oviduct,Vaginae

Condition The experimental condition / phenotype studied according to the Experimental Factor Ontology: Cervical cerclage Cervical Stitch,Tracheloplasty,Cervical Cerclage,Cervical cerclage,cervical cerclage

Group 0 name Corresponds to the control (unexposed) group for case-control studies: Vaginal microbiome of asymptomatic women prior to cerclage

Group 1 name Corresponds to the case (exposed) group for case-control studies: Vaginal microbiome of symptomatic women prior ro cerclage

Group 0 sample size Number of subjects in the control (unexposed) group: 13

Group 1 sample size Number of subjects in the case (exposed) group: 7

Lab analysis

Sequencing type: 16S

16S variable region One or more hypervariable region(s) of the bacterial 16S gene: V1-V2

Sequencing platform Manufacturer and experimental platform used for quantifying microbial abundance: Illumina

Statistical Analysis

Statistical test: LEfSe

Significance threshold p-value or FDR threshold used for differential abundance testing (if any): 0.05

MHT correction Have statistical tests be corrected for multiple hypothesis testing (MHT)?: No

LDA Score above Threshold for the linear discriminant analysis (LDA) score for studies using the popular LEfSe tool: 2

Alpha Diversity

Shannon Estimator of species richness and species evenness: more weight on species richness: unchanged

Signature 1

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Curated date: 2021/01/10

Curator: Shaimaa Elsafoury

Revision editor(s): WikiWorks

Source: Figure 2

Description: Cladogram describing differentially abundant vaginal microbial clades and nodes observed between asymptomatic women and those with symptoms as identified using LEfSe analysis

Abundance in Group 1: increased abundance in Vaginal microbiome of symptomatic women prior ro cerclage

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Streptococcus pseudopneumoniae
Prevotella disiens
Gardnerella vaginalis
Gardnerella

Revision editor(s): WikiWorks

Signature 2

Edit History Delete

Mark reviewed

Your review change was submitted

Needs review

Curated date: 2021/01/10

Curator: Shaimaa Elsafoury

Revision editor(s): WikiWorks

Source: Figure 2

Description: Cladogram describing differentially abundant vaginal microbial clades and nodes observed between asymptomatic women and those with symptoms as identified using LEfSe analysis

Abundance in Group 1: decreased abundance in Vaginal microbiome of symptomatic women prior ro cerclage

NCBI	Quality Control	Links
Lactobacillus crispatus

Revision editor(s): WikiWorks