Abstract
OBJECTIVE: To explore specific characteristics of the vaginal microbiota of pregnant women with cervical insufficiency (CIC) and its association with adverse pregnancy outcomes. METHODS: Records of 337 pregnant women who visited Huzhou Maternity & Child Health Care Hospital between June 2020 and June 2023 were retrospectively analyzed. Based on the diagnosis, the patients were divided into the CIC (n = 225) and control groups (n = 112). The distribution characteristics of vaginal microbiota in pregnant women and its association with adverse pregnancy outcomes were analyzed. RESULTS: One hundred and nine patients in the CIC group showed significantly higher bacterial positivity than the 36 patients in the control group (P<0.05). Bacterial identification results showed a significantly higher number of Ureaplasma urealyticum strains and a considerably lower number of Escherichia coli strains in the CIC group. Among the 225 patients with CIC, 43 had poor pregnancy outcomes. The proportions of Candida albicans, Gardnerella vaginalis, Ureaplasma urealyticum, and Chlamydia were higher in the poor group than in the good group (P < 0.05). The rates of conservative treatment in the group with poor pregnancy outcomes were higher than in the group with good pregnancy outcomes (P<0.05). Logistic analysis showed that Candida albicans, Gardnerella vaginalis, Ureaplasma urealyticum, and Chlamydia were risk factors for adverse pregnancy outcomes in patients with CIC (P<0.05). CONCLUSIONS: The vaginal microbiota of pregnant women with CIC is diverse, with predominantly Ureaplasma urealyticum. Candida albicans, Gardnerella vaginalis, Ureaplasma urealyticum, and Chlamydia are risk factors for adverse pregnancy outcomes in women with CIC.