Influences of gestational diabetes mellitus on the changes in the vaginal microbiota from antepartum to postpartum.

Abstract

Background: No consensus has yet been reached concerning whether there were significant differences in the vaginal microbiota according to maternal gestational diabetes mellitus (GDM) status. This study aimed to compare the vaginal microbiota of women with GDM and normal blood glucose before and after delivery and to prospectively evaluate the influence of GDM on the dynamic changes of vaginal microbiota from antepartum to postpartum.

Methods: This study included 20 GDM patients and 31 average pregnant women who gave birth at the Shenzhen Baoan Women's and Children's Hospital. Vaginal secretions samples were collected one week before delivery (D0), on the first day of delivery (D1), and 42 days after delivery (D42). Vaginal microbiota was detected using 16S rRNA gene sequencing.

Results: There was no significant difference in alpha and beta diversity between the GDM and non-GDM groups at each time point (all p > 0.05). However, the overall change patterns in Shannon and Pielou's evenness index from D0 to D1 to D42 significantly differed between the GDM and non-GDM groups (p = 0.046 and p = 0.032, respectively). The abundance of Lactobacillus decreased obviously after delivery, especially in the GDM group, showing a more severe imbalance of the vaginal microbiota.

Conclusions: We found that GDM affected the succession of vaginal microbiota in the perinatal period. Our findings provided additional evidence for regulating the vaginal microbiota during pregnancy and postpartum to reduce adverse pregnancy outcomes and achieve long-term vaginal health outcomes.