A Cross-Sectional Comparative Study of Vaginal Microbiota and Spontaneous Abortion at a Tertiary Care Hospital in North Karnataka, India

Objective

To compare the vaginal microbiome in women who have undergone spontaneous abortion with a gestational age of less than 20 weeks to that of women who have a continued pregnancy of the same gestational age.

Design

Cross-sectional comparative research design.

Setting

The study was conducted in a tertiary care hospital of North Karnataka, India. In this rural area, many women lack awareness of prenatal care and women’s health information. Given rising rates of spontaneous abortion, studying the impact of the vaginal microbiome on pregnancy outcomes is crucial for raising local awareness.

Participants

Two hundred women; 100 experienced spontaneous abortion within 20 weeks’ gestation, and 100 maintained pregnancy with the same gestational age.

Measures

Vaginal swab was used to detect participants’ vaginal microbiota. DNA was extracted from the vaginal samples; the 16S ribosomal RNA sequencing method was used to identify the organisms present.

Results

A pathogen detection rate of 13.15% (n = 200 women) was found in vaginal cultures. The percentages of bacterial detection in women who had spontaneous abortion and those whose pregnancies continued were 19.9% and 7.9%, respectively (p < .05). Compared to women who sustained their pregnancy, women who experienced spontaneous abortion had five common species: Escherichia coli (48%), Enterococcus faecalis (28%), Enterococcus faecium (12%), Pseudomonas fluorescens (7%), and Pseudomonas cedrina (5%); the most prevalent species among those with sustained pregnancy were Lactobacillus iners (58%), Lactobacillus crispatus (32 %), and E. coli (10%; p < .05).

Conclusion

The vaginal microbiomes of women with spontaneous abortion were more varied and irregularly distributed with bacteria. The bacteria identified could affect a woman’s pregnancy outcome and perhaps be associated with spontaneous abortion. It is vital for nurses to provide education to women who are in the fertile period regarding prenatal screening, sexually transmitted infections, and perineal care.