scholarly journals Non-Lactobacillus-Dominated Vaginal Microbiota Is Associated With a Tubal Pregnancy in Symptomatic Chinese Women in the Early Stage of Pregnancy: A Nested Case–Control Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiao-Feng Ruan ◽  
Ying-Xuan Zhang ◽  
Si Chen ◽  
Xiao-Rong Liu ◽  
Fang-Fang Zhu ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Case Control Study ◽  
Chinese Women ◽  
Disease Diagnosis ◽  
Case Control ◽  
Tubal Pregnancy ◽  
Vaginal Microbiota ◽  
Variable Regions ◽  
Nested Case Control ◽  
Control Study

The features of the vaginal microbiota (VM) community can reflect health status, and they could become new biomarkers for disease diagnosis. During pregnancy, domination of bacteria of the genus Lactobacillus in the VM community is regarded as a keystone because they stabilize the VM by producing antimicrobial compounds and competing adhesion. An altered VM composition provides a marker for adverse pregnancy outcomes. This nested case–control study aimed to characterize the VM in women with a tubal pregnancy (TP) presenting with pain and/or uterine bleeding in early pregnancy. Chinese women with a symptomatic early pregnancy of unknown location were the study cohort. 16S rDNA gene-sequencing of V3–V4 variable regions was done to assess the diversity, structures, taxonomic biomarkers, and classification of the VM community. The primary outcome was the location of the early pregnancy. The VM community in women with a TP showed higher diversity (PD-whole-tree, median: 8.26 vs. 7.08, P = 0.047; Shannon Diversity Index, median: 1.43 vs 0.99, P = 0.03) and showed different structures to those in women with an intrauterine pregnancy (IUP) (R = 0.23, P < 0.01). Bacteria of the genus Lactobacillus were significantly enriched in the IUP group, whereas bacteria of the genera Gardnerella and Prevotella were significantly enriched in the TP group. Lactobacillus abundance could be used to classify the pregnancy location (AUC = 0.81). Non-Lactobacillus-dominated microbiota (≤ 0.85% Lactobacillus) was significantly associated with a TP (adjusted odds ratio: 4.42, 95% confidence interval: 1.33 to 14.71, P = 0.02). In conclusion, among women with a symptomatic early pregnancy, a higher diversity and lower abundance of Lactobacillus in the VM is associated with a TP.

scholarly journals Association Between Vaginal Gardnerella and Tubal Pregnancy in Women With Symptomatic Early Pregnancies in China: A Nested Case-Control Study

2022 ◽  
Vol 11 ◽  
Author(s):  
Yingxuan Zhang ◽  
Si Chen ◽  
Xiaofeng Chen ◽  
Huimin Zhang ◽  
Xuge Huang ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Case Control Study ◽  
Continuous Variable ◽  
Case Control ◽  
Tubal Pregnancy ◽  
Vaginal Microbiota ◽  
Intrauterine Pregnancy ◽  
Female Reproductive Health ◽  
Nested Case Control ◽  
Control Study

The early diagnosis and treatment of ectopic pregnancy (EP) remains a major challenge. Despite a known link between vaginal microbiota and female reproductive health, few studies have focused on the association between vaginal microbiota and pregnancy location. This nested case-control study aimed to characterize the vaginal microbiota in tubal pregnancy (TP) among symptomatic women in early pregnancy. Women with symptomatic early pregnancy of unknown location (PUL) were included in this study. 16S rDNA gene sequencing was performed to assess vaginal microbial diversity and relative abundance. Machine learning and multivariate logistic regression were also used to evaluate the association between Gardnerella and TP. The results indicate that the vaginal microbiome in TP was more diverse (Shannon, p < 0.05) and was different in composition to that of women with intrauterine pregnancy (IUP) (weighted Unifrac, R = 0.08, p = 0.01). The genus Gardnerella was significantly enriched in TP. The XGBoost analysis was able to classify Gardnerella-induced TP more reliably (AUC = 0.621). Moreover, after adjusting potential confounders, our results indicate a robust association between Gardnerella and TP (as a continuous variable, adjusted OR: 12.0, 95% CI: 2.1–67.4, p < 0.01; as a categorical variable (≥0.85%), and adjusted OR: 4.2, 95% CI: 2.0–8.8, p < 0.01). In conclusion, we found that higher virginal Gardnerella levels were associated with TP in women with symptomatic early pregnancy.

scholarly journals Trimethylamine N-Oxide Metabolites in Early Pregnancy and Risk of Gestational Diabetes: A Nested Case-Control Study

2019 ◽  
Vol 104 (11) ◽  
pp. 5529-5539 ◽  
Author(s):  
Xiaoxu Huo ◽  
Jing Li ◽  
Yun-Feng Cao ◽  
Sai-Nan Li ◽  
Ping Shao ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Early Pregnancy ◽  
Case Control Study ◽  
Conditional Logistic Regression ◽  
Full Range ◽  
Case Control ◽  
Conversion Ratio ◽  
Additive Interaction ◽  
Nested Case Control ◽  
Control Study

Abstract Objectives This study aimed to investigate the associations between trimethylamine N-oxide (TMAO) and related metabolites in early pregnancy and the risk of gestational diabetes mellitus (GDM). Design A prospective cohort of 22,302 pregnant women from 2010 to 2012 in Tianjin, China, was used to perform a nested case-control study. A total of 243 women with GDM and 243 women without GDM matched by maternal age (±1 year) were used as cases and controls, respectively. Conditional logistic regression and restricted cubic spline were used to examine the full-range risk associations between individual TMAOs metabolites at the first antenatal care visit with GDM. Trimethylamine conversion ratio (TMAR) was defined as trimethylamine (TMA)/its precursors, and trimethylamine N-oxide conversion ratio (TMAOR) was defined as TMAO/TMA. An additive interaction between high TMAR and low TMAOR indicates a state of TMA accumulation, and a mathematical interaction between high TMAR and high TMAOR indicates accumulation of TMAO. Results TMA was linearly associated with GDM, whereas TMA precursors and TMAO were inversely associated with GDM with clear threshold effects, i.e., 16 nmol/mL for TMAO, 200 nmol/mL for betaine, 112 nmol/mL for l-carnitine, and 110 and 270 nmol/mL for cholinechloride (a U-shaped relationship). Copresence of TMAR >0.35 and TMAOR ≤0.15 was associated with a markedly higher OR (11.16; 95% CI, 5.45 to 22.8), compared with TMAR >0.35 only (OR = 1.71; 95% CI, 0.42 to 6.95) or TMAOR ≤0.15 only (OR = 2.06; 95% CI, 1.09 to 3.90), with a significant additive interaction. However, the mathematical interaction was nonsignificant. Conclusions TMAO metabolites in the early pregnancy were associated with the risk of GDM, whereas TMA was more likely to play a causal role in GDM.

scholarly journals Early Pregnancy Sex Steroids and Maternal Breast Cancer: A Nested Case–Control Study

2014 ◽  
Vol 74 (23) ◽  
pp. 6958-6967 ◽  
Author(s):  
Renée T. Fortner ◽  
Helena Schock ◽  
Rudolf Kaaks ◽  
Matti Lehtinen ◽  
Eero Pukkala ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Pregnancy ◽  
Sex Steroids ◽  
Case Control Study ◽  
Case Control ◽  
Nested Case Control ◽  
Control Study

scholarly journals Early Pregnancy Exposure to Rare Earth Elements and Risk of Gestational Diabetes Mellitus: A Nested Case-Control Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Xiangrong Xu ◽  
Yuanyuan Wang ◽  
Na Han ◽  
Xiangming Yang ◽  
Yuelong Ji ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Rare Earth ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Early Pregnancy ◽  
Case Control Study ◽  
Case Control ◽  
Increased Risk ◽  
Nested Case Control ◽  
Control Study

ObjectiveThe extensive use of rare earth elements (REEs) in many technologies was found to have effects on human health, but the association between early pregnancy exposure to REEs and gestational diabetes mellitus (GDM) is still unknown.MethodsThis nested case-control study involved 200 pregnant women with GDM and 200 healthy pregnant women from the Peking University Birth Cohort in Tongzhou. We examined the serum concentrations of 14 REEs during early pregnancy and analyzed their associations with the risk of GDM.ResultsWhen the elements were considered individually in the logistic regression model, no significant associations were found between REEs and GDM, after adjusting for confounding variables (P > 0.05). In weighted quantile sum (WQS) regression, each quartile decrease in the mixture index for REEs resulted in a 1.67-fold (95% CI: 1.12-2.49) increased risk of GDM. Neodymium (Nd), Praseodymium (Pr), and Lanthanum (La) were the most important contributors in the mixture.ConclusionThe study findings indicated that early pregnancy exposure to lower levels of REE mixture was associated with an increased risk of GDM, and Nd, Pr, and La exhibited the strongest effects in the mixture.

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