Состав и динамика мочепузырной, влагалищной и кишечной микробиоты в трёх триместрах беременности у здоровых женщин

Введение. Динамика микробиоты основных биотопов во время беременности практически не изучена, хотя изменения в данных компартментах имеют важную роль как в функционировании женского организма, так и в развитии плода.

Цель исследования. Изучить динамику и взаимосвязь изменений микробиоты мочевого пузыря, влагалища и кишечника у здоровых беременных женщин в течение трёх триместров (Т-1, 2, 3).

Материалы и методы. Дизайн исследования: одноцентровое сравнительное наблюдательное лонгитюдное исследование. Тридцать из 220 первородящих женщин были отобраны для скрининга в женской консультации в период с 2021 по 2022 год. У всех беременных женщин были взяты пробы в Т-1, 2, 3 для культурального исследования: пробы мочи из мочевого пузыря (средняя порция), мазки из заднего свода влагалища и фекальные массы. После предкультуральной подготовки образцы исследовали на расширенном наборе питательных сред (n = 13) в специальных условиях культивирования (аэробно-анаэробных). По результатам исследований оценивали частоты идентификации (ЧИД), величины микробной нагрузки (ВМН) и коэффициенты взаимной сопряжённости (КВС) микроорганизмов между различными биотопами.

Результаты. Культуральное исследование выявило различные бактерии в каждом биотопе, исследованном во всех триместрах. В моче от Т1 до Т3 наблюдались аэробы и анаэробы с различными ЧИД, но ни один таксон не показал стабильного ЧИД. Во влагалище ЧИД бактерий были аналогичны в моче. Микробиота кишечника была наиболее стабильным биотопом, остававшимся практически неизменным в течение беременности. В моче и влагалище средние показатели ЧИД большинства аэробов и анаэробов не претерпели значительных изменений в течение беременности. В кишечнике ВМН были стабильно выше, чем в мазках из мочи и влагалища. По данным анализа КВС, биотопы мочевой пузырь — влагалище и мочевой пузырь — кишечник показали значительно большее количество взаимосвязей между микроорганизмами во всех Т. Заключение. Наблюдаемая структура микробиоты в течение всех Т ассоциируется с неосложнённым течением беременности. Эти результаты являются значимыми для изучения изменений микробиоты при осложнённой беременности.

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