Specific Expression Of Intestinal Flora In ART Women With Gestational Diabetes Mellitus

Assisted reproductive technology(ART)is mainly applied in the diagnosis and treatment of clinical infertility,providing technical support for the implementation of the two-child policy in our country.However,the increased risks of pregnancy and adverse outcomes of mother and baby have become a serious problem in ART-treated pregnant women,for example,the morbidity of gestational diabetes mellitus (GDM)of ART-treated pregnant women(38.31%)is significantly higher than that of spontaneous pregnancy women(20.34%).The composition and diversity of intestinal flora are closely related to the incidence of GDM and glycemic control.Up to now,the exact pathogenesis of GDM is still unclear;the potential causes may be the changes in metabolism,hormone,and immunoregulation.Hormonal changes during pregnancy can play an important role in the relative insufficiency of insulin secretion.Hormones can affect the composition of intestinal flora and the immune responses,xenoestrogen may cause the maladjustment in intestinal flora.The application of large doses of hormones is required during the pregnancy period for ART-treated pregnant women,which may be the cause for the increase of the morbidity of GDM in ART-treated pregnant women.For this reason,this study selected 20 pregnant women who had regular antenatal care in the obstetrics department of Xiamen University Affiliated Chenggong Hospital(People's Liberation Army 174th Hospital of China).These pregnant women who were fall-term pregnancy,had neither used antibiotics in the past three months nor intestinal diseases were divided into two groups,the ATR-treated pregnant women were designated as the study group,and the spontaneous pregnancy women were designated as the control group.General clinical data,including age,height,weight,gestational weeks,place of residence,pregnancy complications,diet in the last three days,delivery mode,and delivery outcome,were collected.Based on the collected clinical data,the selected pregnant women were further divided into four groups,including ART-treated pregnant women with GDM,ART-treated pregnant women without GDM,spontaneous pregnancy women with GDM,and spontaneous pregnancy women without GDM.Five to ten grams of fecal samples of the selected pregnant women were collected both at childbirth time and at 24 hours before delivery.The differences in phylum,abundant genus,Alpha diversity index,Beta diversity index,and UPGMA-cluster and PCoA analysis of the intestinal flora in fecal samples among these four groups of pregnant women were analyzed.Our results indicated that:(1)Compared to the spontaneous pregnancy women,the number of intestinal floras of ART-treated pregnant women was increased,which mainly appeared as the significant increase in the relative abundance of phylum;the phylum of each bacteria had relative consistent abundance,but the relative ratio of the abundance of Firmicutes to that of Bacteroidetes had significantly difference compared to spontaneous pregnancy women.(2)There were significant decreases iin the Alpha diversity index and richness index of the intestinal floras of ART-treated pregnant women;the Alpha diversity index of the ART-treated pregnant women with GDM was relatively consistent with that of ART-treated pregnant women without GDM,while for the spontaneous pregnancy women the occurrence of GDM had significant effect on the Alpha diversity index mellitus.(3)UPGMA-cluster and PCoA analysis indicated that the Beta diversity of intestinal flora in ART-treated pregnant women with GDM was decreased.Overall,this study indicated that ART may lead to changes in the structure of intestinal flora,and changes in the composition of intestinal flora may indirectly reflect the occurrence of GDM.In women with GDM,the abundance and diversity of intestinal flora are increased and reduced,respectively,and the composition proportion of intestinal flora emerged disorders.This study could provide theoretical basis for revealing the factors that lead to the specific expression of intestinal flora in ART-treated pregnant women with gestational diabetes mellitus,and subsequently promoting the health of ART-treated pregnant women and their children.This study has significance value in clinical practice and needs to further study.