Correlation Between Vaginal Microecology And Recurrent Spontaneous Abortion

Objective: This study aims to understand the changes of vaginal microecology and related enzymes in patients with recurrent spontaneous abortion(RSA),as well as the correlation with RSA,and analyze the related influencing factors.Methods: From June2019 to February 2023,50 RSA patients(RSA group)and 120 patients with normal pregnancy who planned to undergo abortion in the Fifth Affiliated Hospital of Xinjiang Medical University(the control group)were selected as research object.The general data of the research subjects and the test results of vaginal secretions detected by dry chemical enzymatic method combined with wet film microscopy were compared to compare the differences in the vaginal microecology between RSA patients and normal pregnant women.Vaginal microecological status and risk factors analysis.Results: 1)The general information and related clinical factors of the study groups were balanced and comparable,and there was no statistically significant difference in age,body mass index(BMI),smoking or drinking,or not(P>0.05);2)The results of vaginal microecology test showed that the content of lactobacilli was abnormal in 64.0% of the RSA group and 59.2%of the normal control group;there were 10 cases of Vulvovaginal candidiasis(VVC)in the two groups,and the positive rate of VVC in the RSA group was 6%.The positive rate of VVC in the normal control group was 5.8%;there were 17 cases of bacterial vaginosis(Bacterial vaginosis,BV),the positive rate of BV in the RSA group was 23.5%,and the positive rate of BV in the normal control group was 10.8%.vaginitis,TV)0 cases.The results of vaginal micro-ecological morphology detection in the two groups showed that there were no significant differences between RSA and the control group in terms of lactic acid bacteria(P=0.557),bacterial vaginosis(BV)(P=0.575),and candida(VVC)(P=1.0).No statistical significance;3)Comparison of vaginal microecological test results between the two groups: leukocyte esterase(LE)(P=0.035),sialidase(SNA)(P=0.014),proline aminopeptide Enzyme(PIP)(P=0.033),there was a statistically significant difference between the two groups,H2O2(P=0.653),acetylglucosaminidase(NAG)(P=0.182),cleanliness(P=0.590),coagulation Enzyme(GA)(P=0.205),white blood cells(P=0.373),p H value(P=0.557),glucosidase(GLU)(P=0.443),there was no statistically significant difference between the two groups;4)The general information data of the two groups of patients and the variables with P<0.1 in the vaginal microecological morphology and functional detection data were added to the multi-factor binary logistic regression model to evaluate its impact on RSA.Binary Logistic regression analysis with recurrent miscarriage as the dependent variable and age,LE(positive/negative),SNA(positive/negative),and PIP(positive/negative)as independent variables showed that LE(OR=2.346,95%CI =1.007～5.469,P=0.048),suggesting that LE-positive patients are about 2.346 times more likely to develop RSA than LE-negative patients.Conclusions: 1)Changes in vaginal microecology and enzymes are correlated with RSA;2)Positive LE in vaginal secretions is a risk factor for RSA,so attention should be paid to the local inflammatory response caused by changes in vaginal microecology in RSA patients;3)RSA intended for re-pregnancy Before treatment,the vaginal microecology should be evaluated to detect vaginal microecological imbalance in time,and prevent the occurrence and development of RSA related to vaginal microecological imbalance through lifestyle adjustment,vaginal drug intervention,or vaginal lactobacillus supplementation.