CHEN Huayun, WANG Ying, ZHANG Qiongqiong, LIU Jun, ZHANG Lei, LYU Tao, CHEN Rui, HUANG Zhenyu, LIAO Qinping.
Chinese Journal of Clinical Obstetrics and Gynecology. 2025, 26(3): 196-199.
Objective To investigate the significance of vaginal microbiota testing in the early and late pregnancy. Methods A total of 2 142 pregnant women who gave birth at term in Beijing Tsinghua Changgung Hospital from June 2022-December 2023 were selected, study on vaginal microecosystem of the prenatal examination conducted using a self-controlled case series design was included in the descriptive differences of 2 142 full-term deliveries during early and late pregnancy, the differences in flora and morphology of vaginal discharge, as well as thepathogenesis characteristics of vaginitis, were compared with 6~8 weeks of gestation as the early pregnancy group and 36~38 weeks of pregnancy as the late pregnancy group. Results ① In the late pregnancy group, the proportion of vaginal microbiota diversity and microbiota density of ++~+++ were 63.6% and 99.5%, respectively, the proportion of G+b(L) lactobacillus as the dominant bacteria in the vagina was 93.7%, and the proportion of Lactobacillus gradeⅠ~Ⅱa was 93.6%, which were higher than those in the early pregnancy group (60.4%, 98.0%, 91.8% and 91.3%, respectively), and the differences were statistically significant (all P<0.05). ② The infection rate of vaginitis in the late pregnancy group (10.4%) was lower than that in the early pregnancy group (15.9%), and the difference was statistically significant (P<0.001), among which the incidence of simple aerobic vaginitis (AV), bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) in the late pregnancy group were 1.9%, 0.7% and 6.3%, which were lower than those in the early pregnancy group (3.1%、1.4% and 9.2%), and the differences were statistically significant (all P<0.05). The incidences of mixed vaginitis in early and late pregnancy were 2.3% and 1.5%, respectively, and the difference was not statistically significant (P=0.057), the mixed infection rate of AV+BV in early pregnancy (1.0%) was higher than that in late pregnancy (0.4%), and the difference was statistically significant (P=0.028). ③ A total of 67 cases of AV alone in the early pregnancy, of which 10 cases (14.9%) were still in the state of AV infection in the late pregnancy, which was a state of continuous infection during pregnancy. 57 cases were cured, with a cure rate of 85.1%; There were 29 patients with BV alone and 196 patients with VVC alone in the early pregnancy, and 89.7% and 67.4% were cured during pregnancy, respectively. A total of 41 patients with AV alone were detected in the late pregnancy, of which 31 (75.6%) were newly infected. There were 15 patients with BV alone and 135 patients with VVC alone in late pregnancy, of which 12 (80.0%) and 71 (55.6%) were newly infected, respectively. Conclusions There are differences in the types, distribution and morphology of vaginal microbiota in the early and late pregnancy, and the vaginal microbiota detection is used for asymptomatic screening during pregnancy, and the precise treatment of vaginitis is carried out in combination with the clinical symptoms of pregnant women, so as to reduce the incidence of vaginitis in late pregnancy.
