scholarly journals The association between female reproductive tract microbiota and recurrent pregnancy loss: a nested case-control study

Author(s):  
Pirkko Peuranpää

Abstract Objective To study the associations of endometrial and vaginal microbiota with recurrent pregnancy loss (RPL). Design A nested case-control study. Setting Helsinki University Hospital, Finland. Population Women with two or more consecutive pregnancy losses (n=47) and healthy control women without a history of pregnancy loss (n=39). Methods The endometrial and vaginal microbiota compositions, analysed using 16S rRNA gene amplicon sequencing, were compared between RPL women and controls, and between individual vaginal and endometrial samples. The mycobiota composition was analysed using internal transcribed spacer 1 amplicon sequencing for a descriptive summary. The models were adjusted for confounding variables BMI, age, and parity, and FDR-corrected P-values (q-values) were used to define nominal statistical significance at q < 0.05. Main outcome measures Mean relative microbial abundances. Results Lactobacillus crispatus was less abundant in the RPL endometrial samples compared to controls (mean relative abundance 17.2% vs. 45.6%, q = 0.04). Gardnerella vaginalis was more abundant in RPL women than in controls in both endometrial (12.4% vs. 5.8%, q < 0.001) and vaginal samples (8.7% vs. 5.7%, q < 0.01). The individual vaginal and endometrial microbial composition correlated strongly (R = 0.85, P < 0.001). Fungi were detected in 22% of the endometrial and 36% of the vaginal samples. Conclusions Unfavourable reproductive tract microbiota was associated with RPL and may represent a novel risk factor for pregnancy losses.

2020 ◽  
Author(s):  
Yanxia Wang ◽  
Zhaoyan Meng ◽  
Jianyin Pei ◽  
Liu Qian ◽  
Baohong Mao ◽  
...  

Abstract Background: To evaluate the interaction of depression and anxiety with the development of recurrent pregnancy loss (RPL).Methods: A nested case–control study involving 2,558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, self-rating anxiety scale and self-rating depression scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent two years. All patients diagosed RPL were recruited as cases whilst a randomly selected group of women with only one miscarriage in the past were recruited as controls. The logistic regression and the interaction effects between anxiety and depression and RPL were analysed.Results: The prevalence of anxiety (n=325, 28.7% vs. n=278, 19.5%) and depression symptoms (n=550, 48.6% vs. n=589, 41.3%) for the 1,132 RPL cases were higher than 1,426 non-RPL controls (P< 0.001). After adjusting for possible confounding variables, the odds ratio (OR) value, reflecting the multiplicative interaction, was 1.91 (95% CI: 1.50–2.44, P<0.001) for cases with both anxiety and depression symptoms compared with the non-RPL group. The relative excess risk of interaction value, reflecting the additive interaction between anxiety and depression to RPL was 1.15 (95% CI: 0.32–4.21). Moreover, the adjusted OR for RPL cases with mild anxiety and severe depression was 2.77 (95% CI:1.07-44.14, P<0.001) , for RPL cases with severe anxiety and mild depression was 4.23 (95% CI: 1.01–22.21, P<0.001), for RPL cases with severe anxiety and moderate depression was 4.34 (95% CI: 1.03–21.28, P<0.001) and for RPL cases with severe anxiety and severe depression was 5.95 (95% CI: 1.09–45.09, P<0.05).Conclusions: Either depression or anxiety alone could increase the risk of subsequent RPL. Anxiety and depression had a synergistic effect after the first miscarriage which increased the development of subsequent RPL disease.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yanxia Wang ◽  
Zhaoyan Meng ◽  
Jianyin Pei ◽  
Liu Qian ◽  
Baohong Mao ◽  
...  

Abstract Background To evaluate the interaction of depression and anxiety with the development of recurrent pregnancy loss (RPL). Methods A nested case–control study involving 2558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, self-rating anxiety scale and self-rating depression scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent 2 years. All patients diagosed RPL were recruited as cases whilst a randomly selected group of women with only one miscarriage in the past were recruited as controls. The logistic regression and the interaction effects between anxiety and depression and RPL were analysed. Results The prevalence of anxiety (n = 325, 28.7% vs. n = 278, 19.5%) and depression symptoms (n = 550, 48.6% vs. n = 589, 41.3%) for the 1132 RPL cases were higher than 1426 non-RPL controls (P < 0.001). After adjusting for possible confounding variables, the odds ratio (OR) value, reflecting the multiplicative interaction, was 1.91 (95% CI 1.50–2.44, P < 0.001) for cases with both anxiety and depression symptoms compared with the non-RPL group. The relative excess risk of interaction value, reflecting the additive interaction between anxiety and depression to RPL was 1.15 (95% CI 0.32–4.21). Moreover, the adjusted OR for RPL cases with mild anxiety and severe depression was 2.77 (95% CI 1.07–44.14, P < 0.001), for RPL cases with severe anxiety and mild depression was 4.23 (95% CI 1.01–22.21, P < 0.001), for RPL cases with severe anxiety and moderate depression was 4.34 (95% CI 1.03–21.28, P < 0.001) and for RPL cases with severe anxiety and severe depression was 5.95 (95% CI 1.09–45.09, P < 0.05). Conclusions Either depression or anxiety alone could increase the risk of subsequent RPL. Anxiety and depression had a synergistic effect after the first miscarriage which increased the development of subsequent RPL disease.


2020 ◽  
Author(s):  
Yanxia Wang ◽  
Zhaoyan Meng ◽  
Jianyin Pei ◽  
Liu Qian ◽  
Baohong Mao ◽  
...  

Abstract Background: To evaluate the depression–anxiety interaction with the development of recurrent pregnancy loss (RPL). Methods: A nested case–control study involving 2,558 participants was conducted with data from the prospective Miscarriage Woman Cohort study between 2017 and 2019 in the province of Gansu, China. The questionnaire data, the Self-Rating Anxiety Scale and the Self-Rating Depression Scale were collected after each participant’s first miscarriage. Information on RPL outcomes was obtained from the medical records within the subsequent two years. The logistic regression and the addition and multiplication interaction effects between anxiety and depression to RPL were analysed.Results: The prevalence of anxiety (28.7% vs. 19.5%) and depression symptoms (48.6% vs. 41.3%) for the 1,132 RPL cases were higher than 1,426 non-RPL controls (P< 0.001). After adjustment for possible confounding variables, compared with the non-RPL participants without depression and anxiety symptoms, the odds ratio (OR) value, reflecting the multiplicative interaction, was 2.788 (95%CI: 1.511–5.144, P < 0.001) for cases with both anxiety and depression symptoms. Moreover, among these, the OR for cases with mild anxiety and severe depression was 5.369 (95%CI: 1.074–26.832, P < 0.001), and the OR for cases with severe anxiety and mild depression was 5.339 (95%CI: 1.033–27.590, P < 0.001). The relative excess risk of interaction value (RERI), reflecting the additive interaction between anxiety and depression to RPL was also 1.148 (95%CI: 0.316–4.212).Conclusions: Either depression or anxiety alone could increase risk of subsequent RPL. There also was a synergistic effect of anxiety and depression after the first miscarriage that increased the development of subsequent RPL disease.


2016 ◽  
Vol 11 (6) ◽  
pp. 471-475 ◽  
Author(s):  
Seyed Mehdi Sajjadi ◽  
Abbas Khosravi ◽  
Jalil Pakravesh ◽  
Zahra-soheila Soheili ◽  
Shahram Samiei ◽  
...  

2017 ◽  
Vol 32 (12) ◽  
pp. 2029 ◽  
Author(s):  
Kyu Ri Hwang ◽  
Young Min Choi ◽  
Jin Ju Kim ◽  
Sung Ki Lee ◽  
Kwang Moon Yang ◽  
...  

Author(s):  
Mehdi Alizadeh ◽  
Mahboobeh Nasiri ◽  
Morteza Samadi ◽  
Nasrin Ghasemi ◽  
Ali Moradi

Background: Recurrent pregnancy loss (RPL) refers to the incidence of two or more abortions before the first half of pregnancy. Oxidative stress has been hypothesized to play a central role in RPL. Objective: To investigate the relationship between Q192R and L55M polymorphisms of PON1 as antioxidant enzyme and the risk of RPL. Materials and Methods: In this case–control study, 110 women with RPL (case) and 110 healthy fertile women (control) referred to the Research and Clinical Center for Infertility, Shiraz, Iran were enrolled. Genomic DNA was extracted from the peripheral blood in all participants. Polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism method. Results: Statistical analysis of Q192R polymorphism showed a significant difference for the RR genotype between the case and control group (OR = 11, CI = 1.39–86.87, p = 0.005) but none for the QR and QQ genotypes. No significant association was observed between the R and Q allelic frequency in the RPL participants compared to the control group (p = 0.53). Also, statistical analysis of the L55M polymorphism for MM genotype in the case group compared with the control group showed a significant difference (OR = 3.59, CI = 0.97–13.30, p = 0.042), but none for the LM and LL genotypes. Conclusion: The findings showed a significant correlation between the Q192R polymorphisms and the L55M PON1 enzyme and RPL in this study population. Key words: Pregnancy, Abortion, PON1, Polymorphism, Recurrent pregnancy loss.


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