Adverse pregnancy outcomes in women with type 1 diabetes are associated with multiple alterations in the vaginal microbiome

Roth-Schulze, AJ; Zozaya-Valdes, E; Bandala-Sanchez, E; ENDIA Study Group; Ngui, KM; Naselli, G; Oakey, H; Ashwood, P; Martin, G; Brown, JD; Thomson, RL; Colman, PG; Wentworth, JM; Vuillermin, PJ; Hunyh, T; Soldatos, G; Couper, JJ; Penno, MAS; Harrison, LC

Author(s): Roth-Schulze, AJ; Zozaya-Valdes, E; Bandala-Sanchez, E; ENDIA Study Group; Ngui, KM; Naselli, G; Oakey, H; Ashwood, P; Martin, G; Brown, JD; Thomson, RL; Colman, PG; Wentworth, JM; Vuillermin, PJ; Hunyh, T; Soldatos, G; Couper, JJ; Penno, MAS; Harrison, LC;
Details: Publication Year 2025-11,Volume 68,Issue #11,Page 2552-2566
Journal Title: Diabetologia
Abstract: AIMS/HYPOTHESIS: The vaginal microbiome has been linked to adverse pregnancy outcomes, which are markedly increased in women with type 1 diabetes. To investigate this relationship, we profiled the vaginal microbiome in pregnant women with and without type 1 diabetes, and in relation to pre-term birth (PTB) and pre-eclampsia (PE) in women with type 1 diabetes. METHODS: Bacterial and fungal microbiomes were analysed by 16S rRNA gene and internal transcribed spacer 1 sequencing, respectively, in the third trimester of 310 pregnancies (160 with type 1 diabetes) for bacteria, and 147 pregnancies (70 with type 1 diabetes) for fungi. RESULTS: The vaginal microbiome was altered by type 1 diabetes in pregnancy, with an increase in the bacterial species Lactobacillus iners and Lactobacillus jensenii, and in the anaerobic genera Gardnerella, Anaerococcus, Prevotella, Dialister, Peptoniphilus and others that are associated with vaginal dysbiosis. In addition, the abundance of the fungal species Malassezia restricta was increased in women with type 1 diabetes. These changes were associated with increased risks of PTB and PE. PTB was associated with higher bacterial alpha diversity, decreased abundance of Lactobacillus reuteri, and increased abundance of Malassezia fungal genus, family Malasseziaceae and order Malasseziales. PE was associated with higher bacterial alpha diversity, increased abundance of Gardnerella vaginalis and decreased abundance of Candida albicans. CONCLUSIONS/INTERPRETATION: Adverse pregnancy outcomes in women with type 1 diabetes are reflected by distinct changes in the vaginal microbiome. This highlights the importance of monitoring and managing the vaginal microbiome in high-risk pregnancies, particularly those complicated by type 1 diabetes. Early detection and treatment of risk-associated taxa, e.g. G. vaginalis in the case of PE, could potentially improve vaginal health and pregnancy outcomes in women with type 1 diabetes.
Publisher: Springer
Keywords: Humans; Female; Pregnancy; *Diabetes Mellitus, Type 1/microbiology/complications; *Microbiota/physiology/genetics; *Vagina/microbiology; Pregnancy Outcome; Adult; *Pregnancy in Diabetics/microbiology; Pre-Eclampsia/microbiology; Premature Birth/microbiology; Dysbiosis/microbiology; RNA, Ribosomal, 16S/genetics; Candida; Gardnerella vaginalis; Malassezia; 16S rRNA gene; Community state types; Its1; Internal transcribed spacer 1; Lactobacilli; Microbiome; Mycobiome; Pre-eclampsia; Pre-term birth; T1d; Type 1 diabetes
Research Division(s): Immunology
PubMed ID: 40775532
Publisher's Version: https://doi.org/10.1007/s00125-025-06509-0
Open Access at Publisher's Site: https://doi.org/10.1007/s00125-025-06509-0
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-09-23 11:15:49

Last Modified: 2025-10-20 01:59:39