Intestinal dysbiosis during pregnancy: the norm or pathology?

Abstract

BACKGROUND: An interest in the study of intestinal microflora has grown among scientists in recent years. This is due to the active development of molecular genetic techniques. The obvious importance of gut microbiota for pregnancy has been established in some scientific works; however, the number of studies devoted to this issue is small. AIM: This study was aimed to assess the qualitative and quantitative composition of the intestinal microflora in pregnant women. MATERIALS AND METHODS: The study involved 200 women aged 18 to 43 years in pregnancy from six to 22 weeks. A qualitative and quantitative analysis of the intestinal and vaginal microbiota was performed by real-time PCR. RESULTS: Intestinal dysbacteriosis was detected in 100% of the examined pregnant women. Grade I was detected in 64.5% (n = 129), grade II in 26.5% (n = 53), and grade III in 9% (n = 18) of cases. A decrease in the concentrations of resident bacteria was noted in all pregnant women; in addition, in women with moderate and severe dysbacteriosis, opportunistic microorganisms (Clostridium difficile, Enterobacter spp., Streptococcus spp., and Campylobacter spp.) were detected in quantities exceeding the formally permissible values. The analysis of the course of pregnancies showed that grade I and grade II intestinal dysbacteriosis is a risk factor for early pregnancy complications (OR = 0.2, p = 0.00), thus confirming the role of intestinal microbiocenosis in miscarriage. CONCLUSIONS: Pregnancy is a predisposing factor for changes in the intestinal microflora, as evidenced by the detection of intestinal dysbiosis in 100% of pregnant women in the main and control study groups. Considering that the majority of women with a normal pregnancy were diagnosed with grade I intestinal dysbiosis, it can be assumed that this degree of dysbiosis is the norm of pregnancy. Thus, the identification of moderate or severe intestinal dysbiosis should be associated with complications of early pregnancy.