Evidence map›Paper›PMID 40775532›Full record

ArticleDiabetologia2025

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

Alexandra J Roth-Schulze, Esther Bandala-Sanchez, Katrina M Ngui, Gaetano Naselli, Helena Oakey, Patricia Ashwood, Guinevere Martin, James D Brown, Enrique Zozaya-Valdés, Rebecca L Thomson and 9 more

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In one paragraph

Article in Diabetologia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Observational
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Alexandra J Roth-SchulzeWalter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Esther Bandala-SanchezWalter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Katrina M NguiWalter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Gaetano NaselliWalter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Helena OakeyRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Patricia AshwoodRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Guinevere MartinRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
James D BrownRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Enrique Zozaya-ValdésWalter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Rebecca L ThomsonRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Peter G ColmanDepartment of Diabetes and Endocrinology, Royal Melbourne Hospital, Melbourne, VIC, Australia.
John M WentworthWalter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
Peter J VuillerminFaculty of School of Medicine, Deakin University, Geelong, VIC, Australia.
Tony HunyhChildren's Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane, QLD, Australia.
Georgia SoldatosMonash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Jennifer J CouperRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Megan A S PennoRobinson Research Institute, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
Leonard C HarrisonWalter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia. harrison@wehi.edu.au.ORCID http://orcid.org/0000-0002-2500-8944
ENDIA Study Group

Funding

JDRF 1-SRA-2018-543-S-BLeona M. and Harry B. Helmsley Charitable Trust 3-SRA-2020-966-M-N
6 · The paper itself

Abstract

aims/hypothesisThe 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.

methodsBacterial 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.

resultsThe 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/

interpretationAdverse 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.

Indexed as

Diabetes Mellitus, Type 1MicrobiotaPregnancy in DiabeticsVaginaAdultDysbiosisFemaleHumansPre-EclampsiaPregnancyPregnancy OutcomePremature BirthRNA, Ribosomal, 16SRNA, Ribosomal, 16S16S rRNA geneCandidaCommunity state typesGardnerella vaginalisInternal transcribed spacer 1ITS1LactobacilliMalasseziaMicrobiomeMycobiomePre-eclampsiaPregnancyPre-term birthT1DType 1 diabetes

Identifiers

PMID40775532
PMCPMC12534357

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.