摘要
目的 探讨产妇产后抑郁(PPD)变化轨迹与阴道菌群变化之间的关系.方法 于2021年9月至2022年10月在本院选取102例产妇作为研究对象,在产后2～3天、产后6周、产后3个月、产后6个月进行随访并通过爱丁堡产后抑郁量表(EPDS)测量PPD,且于产后6个月时收集产妇阴道菌群生物信息数据.分析产后6个月内产妇PPD变化轨迹及其与阴道菌群之间的关系.结果 最终确定两类模型作为代表产后抑郁变化轨迹的最佳模型:第一类(n=37,36.3％)标记为递增型组,第二类(n=65,63.7％)标记为低稳定组.递增型组表现出比低稳定组更高的物种数(393.7±48.1 vs.368.2±65.8,t=4.36,P=0.013)、丰富度(Chao1:429.7±55.0 vs.403.0±72.0,t=3.87,P=0.020)和生物多样性(香农指数:5.25±0.46 vs.5.02±0.59,t=3.95,P=0.018).与低稳定组相比,递增型组产妇的拟杆菌、粪大肠杆菌、帕拉普氏菌、副普雷沃菌显著较低(16.85％vs.22.69％,7.87％vs.10.20％,0.10％vs.0.31％,0.01％vs.0.11％,P＜0.05);但未鉴定的毛螺旋菌、未鉴定的梭菌、毛螺菌、未鉴定的丹毒丝菌、柯林斯氏菌和拉克氏梭状芽胞杆菌属显著较高(6.89％vs.4.58％,1.50％vs.0.77％,1.27％vs.0.76％,1.04％vs.0.66％,0.97％vs.0.36％,0.80％vs.0.54％,P＜0.05).两组产妇阴道菌群相对丰度比较具有显著差异(LDA值＞4,P＜0.05).结论 递增型组女性的阴道微生物群数目、丰富度和多样性较低稳定组更高,提示与PPD的发生发展相关.
Abstract
Objective To explore the relationship between postpartum depression(PPD)trajectories and changes in the vaginal flora in mothers.Methods From September 2021 to October 2022,102 postpartum women were selected as study participants in our hospital.Follow-ups were conducted at 2-3 days,6 weeks,3 months,and 6 months postpartum,and PPD was measured using the Edinburgh Postnatal Depression Scale(EPDS).Vaginal flora data were collected at 6 months postpartum.The study analyzed the trajectories of PPD changes within 6 months postpartum and their relationship with the vaginal flora.Results Two models were ultimately identified as the best models representing PPD trajectories:the first group(n=37,36.3％)was labeled as the increasing group,and the second group(n=65,63.7％)was labeled as the low-stable group.The increasing group showed a higher number of species(393.7±48.1 vs.368.2±65.8,t=4.36,P=0.013),richness(Chao1:429.7±55.0 vs.403.0±72.0,t=3.87,P=0.020)and biodiversity(Shannon index:5.25±0.46 vs.5.02±0.59,t=3.95,P=0.018)compared to the low-stable group.Compared with the low-stable group,the increasing group showed significantly lower levels of Bacteroides,Escherichia coli,Parabacteroides,and Prevotella(16.85％vs.22.69％,7.87％vs.10.20％,0.10％vs.0.31％,0.01％vs.0.11％,P＜0.05).However,Helicobacter(unidentified),Clostridium(unidentified),Helicobacter spp.,Erysipelotrichaceae(unidentified),Collinsella,and Lachnospiraceae were significantly higher(6.89％vs.4.58％,1.50％vs.0.77％,1.27％vs.0.76％,1.04％vs.0.66％,0.97％vs.0.36％,0.80％vs.0.54％,P＜0.05).The relative abundance of vaginal flora between the two groups of postpartum women showed significant differences(LDA score＞4,P＜0.05).Conclusion Women in the increasing group had a higher number,richness,and diversity of vaginal flora compared to the low-stable group,suggesting a correlation with the occurrence and progression of PPD.
维普
万方数据