Background Preeclampsia (PE) is a condition of high blood pressure that is usually concurrent with proteinuria in pregnancy. PE complicates the management of both maternal and fetal health and contributes to most adverse pregnancy outcomes, but the mechanism underlying the development of PE remains unclear. In this study, we performed a case-control study to compare the gut microbiota of PE (n = 26), abnormal placental growth (APG, n = 25) and healthy pregnant women (n = 28) and analyzed the potential pathogenic role of gut microbiota in PE progression. Results The clinical pathophysiological state did not affect the bacterial diversity, while the compositions of the gut microbiota were significantly altered in both the PE and APG groups compared with healthy pregnant women. At the phylum level, TM7 was significantly increased in women with APG. Heterogeneity was observed at the genus level, especially in genera with positive LDA scores, suggesting the stage-dependent effect of gut microbiota on the development of PE. The beneficial bacterium Lactobacillus was markedly depleted in the PE and APG groups but was only correlated with blood pressure (BP) and proteinuria levels in the PE group. Two different bacterial taxa belonged to Lactobacillus showed different correlations (OTU255 and OTU784 were significantly related to PE and APG, respectively). Conclusions Our results indicated that shifts in the gut microbiota might occur from the early stages of the development of PE, which is of possible etiological and therapeutic importance.

Fetal growth restriction (FGR) is a prevalent obstetric condition. This study aimed to investigate the role of Toll-like receptor 9 (TLR9) in regulating the inflammatory response and gut microbiota structure in FGR. An FGR animal model was established in rats, and ODN1668 and hydroxychloroquine (HCQ) were administered. Changes in gut microbiota structure were assessed using 16S rRNA sequencing, and fecal microbiota transplantation (FMT) was conducted. HTR-8/Svneo cells were treated with ODN1668 and HCQ to evaluate cell growth. Histopathological analysis was performed, and relative factor levels were measured. The results showed that FGR rats exhibited elevated levels of TLR9 and myeloid differentiating primary response gene 88 (MyD88). In vitro experiments demonstrated that TLR9 inhibited trophoblast cell proliferation and invasion. TLR9 upregulated lipopolysaccharide (LPS), LPS-binding protein (LBP), interleukin (IL)-1β and tumor necrosis factor (TNF)-α while downregulating IL-10. TLR9 activated the TARF3-TBK1-IRF3 signaling pathway. In vivo experiments showed HCQ reduced inflammation in FGR rats, and the relative cytokine expression followed a similar trend to that observed in vitro. TLR9 stimulated neutrophil activation. HCQ in FGR rats resulted in changes in the abundance of Eubacterium_coprostanoligenes _group at the family level and the abundance of Eubacterium_coprostanoligenes _group and Bacteroides at the genus level. TLR9 and associated inflammatory factors were correlated with Bacteroides , Prevotella , Streptococcus , and Prevotellaceae_Ga6A1 _group. FMT from FGR rats interfered with the therapeutic effects of HCQ. In conclusion, our findings suggest that TLR9 regulates the inflammatory response and gut microbiota structure in FGR, providing new insights into the pathogenesis of FGR and suggesting potential therapeutic interventions.

Background: For pregnant women who develop complications during the third trimester of pregnancy, or who have not given birth naturally after more than 41 weeks of pregnancy, artificial induction of labor is needed in order to obtain a healthy outcome for both the mother and the child. The 2014 edition of the Guidelines for Promoting Cervical Maturation and Delivery in Late Pregnancy point out that the use of COOK cervical ripening balloons to mechanically dilate the cervix can be used in the third trimester to promote cervical ripening and labor induction [1]. The disadvantage is the risk of infection, premature rupture of membranes, and umbilical cord prolapse [2]. The safety of balloon induction for pregnant women colonized by group B streptococcus (GBS) is currently lacking in multi-center clinical research data. This article will study the safety of COOK double balloon induction in pregnant women colonized by GBS.Methods: A total of 1,681 pregnant women who used COOK double balloons for cervical ripening in Changsha Maternity and Child Health Hospital from September 2018 to September 2020 were selected as the research subjects, from which 125 cases with colonization of group B streptococcus in the reproductive tract were selected as the observation group. Pregnant women without group B streptococcus colonization (N = 1556) served as the control group. This study compares the two groups’ delivery methods, postpartum complications, and neonatal conditions. Results: The rate of transition to cesarean section in the observation group was slightly higher, and the difference was statistically significant (p = 0.049). The rate of postpartum hemorrhage was higher than that of the control group (p < 0.05). Although chorioamnionitis increased compared to the control group, the difference was not significant (p > 0.05). The comparison of newborn birth indicators between the two groups showed no statistically significant difference (p > 0.05). Conclusion: When pregnant women with colonization of group B streptococcus of the genital tract use the COOK double balloon to promote cervical ripening, the success rate of labor induction is high. Use of the balloon does not increase the cesarean section rate and the incidence of chorioamnionitis, nor does it increase the risk of neonatal infection. However, the risk of postpartum hemorrhage increases, and it is necessary to take active measures to reduce this risk.

Pre-eclampsia (PE) is a condition of high blood pressure which usually concurrent with proteinuria in pregnancy. PE complicate the management of both maternal and fetal health and contribute the most of adverse pregnancy outcome, but the mechanism underlying the development of PE remains unclear. In this study, we performed a case-control study to compare the gut microbiota of PE, abnormal placental growth (APG) and health pregnant women and analyzed the potential pathogenic role of gut microbiota in PE progression. Although the clinical pathophysiological state did not affect the bacterial diversity, the compositions of the gut microbiota were significant altered in both PE and APG groups when compared with health pregnant woman. At phylum level, TM7 was significantly increased in woman with APG and, although with no significance, the percentage of Proteobacteria were extended especially in patient with PE. Heterogeneity was observed at genus level, especially in the genus with positive LDA scores suggested the stage-dependent manner effort of gut microbiota to the development of PE. The beneficial bacteria lactobacillus was markedly depleted in PE and APG group but only correlated with blood pressure (BP) and proteinuria levels in PE group and, different lactobacillus species shown different contributions (otu255 and otu784 were significant related to PE and APG separately). Our results indicated that shifts in the gut microbiota might occur from the early stages of the development of PE, which is of possible etiological and therapeutic importance.