The composition and stability of the vaginal microbiota of normal pregnant women is different from that of non-pregnant women

Roberto Romero, Sonia S Hassan, Pawel Gajer, Adi L Tarca, Douglas W Fadrosh, Lorraine Nikita, Marisa Galuppi, Ronald F Lamont, Piya Chaemsaithong, Jezid Miranda, Tinnakorn Chaiworapongsa, Jacques Ravel, Roberto Romero, Sonia S Hassan, Pawel Gajer, Adi L Tarca, Douglas W Fadrosh, Lorraine Nikita, Marisa Galuppi, Ronald F Lamont, Piya Chaemsaithong, Jezid Miranda, Tinnakorn Chaiworapongsa, Jacques Ravel

Abstract

Background: This study was undertaken to characterize the vaginal microbiota throughout normal human pregnancy using sequence-based techniques. We compared the vaginal microbial composition of non-pregnant patients with a group of pregnant women who delivered at term.

Results: A retrospective case-control longitudinal study was designed and included non-pregnant women (n = 32) and pregnant women who delivered at term (38 to 42 weeks) without complications (n = 22). Serial samples of vaginal fluid were collected from both non-pregnant and pregnant patients. A 16S rRNA gene sequence-based survey was conducted using pyrosequencing to characterize the structure and stability of the vaginal microbiota. Linear mixed effects models and generalized estimating equations were used to identify the phylotypes whose relative abundance was different between the two study groups. The vaginal microbiota of normal pregnant women was different from that of non-pregnant women (higher abundance of Lactobacillus vaginalis, L. crispatus, L. gasseri and L. jensenii and lower abundance of 22 other phylotypes in pregnant women). Bacterial community state type (CST) IV-B or CST IV-A characterized by high relative abundance of species of genus Atopobium as well as the presence of Prevotella, Sneathia, Gardnerella, Ruminococcaceae, Parvimonas, Mobiluncus and other taxa previously shown to be associated with bacterial vaginosis were less frequent in normal pregnancy. The stability of the vaginal microbiota of pregnant women was higher than that of non-pregnant women; however, during normal pregnancy, bacterial communities shift almost exclusively from one CST dominated by Lactobacillus spp. to another CST dominated by Lactobacillus spp.

Conclusion: We report the first longitudinal study of the vaginal microbiota in normal pregnancy. Differences in the composition and stability of the microbial community between pregnant and non-pregnant women were observed. Lactobacillus spp. were the predominant members of the microbial community in normal pregnancy. These results can serve as the basis to study the relationship between the vaginal microbiome and adverse pregnancy outcomes.

Figures

Figure 1
Figure 1
Heatmap of percentage abundance of microbial taxa found in the vaginal microbial communities of 22 normal pregnant women who delivered at term and 32 non-pregnant women sampled longitudinally. Ward linkage hierarchical clustering of Jensen-Shannon metric identified five community state types (CST I, II, III, IV-A and IV-B). The upper color bar shows the five community state types while the lower color bar shows the pregnancy status of each sample (NP: Non Pregnant; TD: Term Delivery).
Figure 2
Figure 2
Profiles of community state types for pregnant women who delivered at term as a function of gestational age. Gestational age at delivery is indicated by blue solid circles.
Figure 3
Figure 3
Estimates of community change over time in non-pregnant and pregnant women who delivered at term. (A) Jensen-Shannon distances between each community state and the mean community state for each subject. The larger the distance, the higher the instability of the microbial community within a subject. The mean within-subject log Jensen-Shannon distance of pregnant women was significantly lower than that for non-pregnant women (difference in means -0.473 log units; that is, 1.6-fold lower Jensen-Shannon distance, P < 0.001). (B) Jensen-Shannon distance between each community state and the mean community state of all samples assigned to CST IV-A and CST IV-B. The higher the distance, the less frequently a community enters CST IV-A or CST IV-B. The mean log Jensen-Shannon distance of pregnant women was significantly higher than that for non-pregnant women (difference in means 0.13 log units; that is, 1.14-fold, P < 0.001).

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Source: PubMed

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