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Vaginal swabs were collected in the third trimester and analysed by full-length 16S rRNA gene sequencing. Associations between vaginal microbiota composition, maternal glycaemic measures, and fetal birthweight percentile (FBW%ile) were evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall vaginal microbial composition differed between groups despite similar alpha diversity. Beta diversity analyses showed significant separation between the women with GDM and the control group (\n                      <jats:italic>R<\/jats:italic>\n                      =0.068,\n                      <jats:italic>p<\/jats:italic>\n                      =0.011 by ANOSIM).\n                      <jats:italic>Lactobacillus-<\/jats:italic>\n                      dominated communities were less frequent in women with GDM than in control participants (73.3% vs 86.6%,\n                      <jats:italic>p<\/jats:italic>\n                      =0.029), with reduced\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      abundance (79.8% vs 87.4%, nominal\n                      <jats:italic>p<\/jats:italic>\n                      =0.020) and increased\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      abundance (9.7% vs 1.4%, nominal\n                      <jats:italic>p<\/jats:italic>\n                      =0.011). Within the GDM group,\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      abundance correlated positively with fasting glucose levels (\n                      <jats:italic>r<\/jats:italic>\n                      =0.3617, nominal\n                      <jats:italic>p<\/jats:italic>\n                      =0.007) and inversely with FBW%ile (\n                      <jats:italic>r<\/jats:italic>\n                      =\u22120.2774, nominal\n                      <jats:italic>p<\/jats:italic>\n                      =0.032). Stratification by FBW%ile (&lt;50% vs \u226550%) showed a higher proportion of non-\n                      <jats:italic>Lactobacillus-<\/jats:italic>\n                      dominated communities (44.4% vs 12.1%,\n                      <jats:italic>p<\/jats:italic>\n                      =0.001) and higher\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      abundance (15.0% vs 3.2%, nominal\n                      <jats:italic>p<\/jats:italic>\n                      =0.020) in the low FBW%ile subgroup. Associations with\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      were attenuated in sensitivity analyses that excluded samples with extreme\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      abundance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\/interpretation<\/jats:title>\n                    <jats:p>\n                      Late-pregnancy GDM was associated with modest shifts in vaginal microbial structure, characterised by reduced\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      dominance and relative enrichment of\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      . Exploratory analyses of associations of\n                      <jats:italic>Gardnerella<\/jats:italic>\n                      with maternal fasting glucose levels and fetal growth suggest that variation in the vaginal microbial environment may contribute to metabolic and fetal growth heterogeneity in women with GDM.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00125-026-06770-x","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:21:38Z","timestamp":1781194898000},"page":"2472-2486","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gardnerella enrichment in the vaginal microbiome of women with gestational diabetes mellitus is associated with lower fetal birthweight percentiles"],"prefix":"10.1007","volume":"69","author":[{"given":"Yilin","family":"Fu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nary","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phannaroat","family":"Sourn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengqi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weidong","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huihui","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoshuai","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianli","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9659-0644","authenticated-orcid":false,"given":"Zizhuo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0881-775X","authenticated-orcid":false,"given":"Wencheng","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"issue":"3","key":"6770_CR1","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1038\/s41564-022-01083-2","volume":"7","author":"M France","year":"2022","unstructured":"France M, Alizadeh M, Brown S, Ma B, Ravel J (2022) Towards a deeper understanding of the vaginal microbiota. 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YF and NL performed the data analysis, and drafted the manuscript. PS contributed to sample collection and data curation. MZ, WT, HY, JY, YC, JWa, XZ, XL, SW, LF, JWu and ZW participated in investigation and data curation. LF, JWu and SW provided clinical guidance and contributed to the interpretation. SW and WD contributed to obtaining funding. JWu, ZW and WD supervised the study and critically revised the manuscript. All authors reviewed the manuscript critically for important intellectual content and approved the final version to be published. WD is responsible for the integrity of the work as a whole.","order":5,"name":"Ethics","label":"Contribution statement","group":{"name":"EthicsHeading","label":"Ethics"}}]}}