ORIGINAL RESEARCH
Predicting preterm birth based on vaginal microbiota assessment by real-time PCR in the first trimester
1 Ural State Medical University, Yekaterinburg, Russia
2 ‘Garmonia’ Medical Center, Yekaterinburg, Russia
Correspondence should be addressed: Еkaterina S. Voroshilina
Tveritina, 16, Yekaterinburg, 620100, Russia; moc.liamg@anilihsorov
Author contribution: Voroshilina ES — organization of the study, conducting real-time PCR, data analysis, writing the article; Khayutin LV — organization of the study,data analysis, patient selection, writing the article; Kudryavtseva EV, Kovalev VV — statistical processing, data analysis, writing the article; Plotko EE — organization of the study,data analysis, patient selection, writing the article.
Compliance with ethical standards: the study was approved by the Ethics Committee of Ural State Medical University, Federal State Budget Educational Institution of Higher Education under the Ministry of Health of the Russian Federation (Protocol № 7 dated March 28, 2011). All patients signed the informed written consent to participation in the study.
Detecting high risk of preterm birth (PB) early makes its prevention possible. The aim of the work was to develop a mathematical predictive model for assessing the risk of preterm birth based on a quantitative analysis of the vaginal microbiota in the first trimester of pregnancy. The study included 199 pregnant women, i.e. 41 pregnancies that ended in preterm birth, and 158 — in term birth. Vaginal microbiota was analyzed in all patients in the 1st trimester of pregnancy by quantitative real-time PCR (qPCR). The method of dicriminant analysis was used to develop a predictive model. A method for predicting PB was developed with the calculation of the PRIMA prognostic index (Premature Birth. Index Of Microbiological Analysis). If the value of PRIMA > 0 – the risk of premature birth is low, if PRIMA < 0 – the risk is high. The sensitivity and specificity of the method are respectively 70.7% and 79.75%, the effectiveness is 77.89%. Evaluation of vaginal microbiota in the 1st trimester makes it possible to identify a high-risk group of PB and perform timely preventive measures.
Keywords: premature birth, real-time PCR, vaginal microbiota, prediction, Femoflor-16, discriminant analysis