{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:47:22Z","timestamp":1777916842414,"version":"3.51.4"},"reference-count":39,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>One of the major risks of preterm birth is a history of conization. However, the risk of infection due to this procedure is still not well known. Using next-generation sequencing, we aimed to reveal the influence of conization on vaginal microbiota in the following pregnancy, and their relationship between spontaneous preterm birth (sPTB).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study including 133 pregnant patients, of whom 25 had conization histories and 108 did not. Vaginal microbiome samples were collected using swabs by an obstetrician upon inclusion in the first trimester and during delivery. V1\u2013V2 of the 16S rRNA gene were amplified and analyzed to identify the bacteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The conization group had a significantly lower delivery week (34 weeks vs. 36 weeks,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003) and higher sPTB rate (64% vs. 8.3%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009\u2264\u20090.001) than the control group. In the conization group, alpha (Chao 1,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.02; phylogenetic diversity whole tree,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04) and beta diversity (permutational multivariate analysis of variance test,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.04) of the vaginal microbiota was significantly higher during delivery in patients who delivered preterm than in those who delivered term. Community-state type IV in the first trimester was significantly associated with sPTB (overall odds ratio 3.80, 95% confidence interval 1.33\u201310.8,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Conization is a risk factor for sPTB. Increased risk of sPTB in patients after conization may belong to the vulnerable defense mechanism, due to the shortened cervix and decreased cervical mucus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2022.0440","type":"journal-article","created":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T15:53:06Z","timestamp":1675180386000},"page":"375-384","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Vaginal Microbiota and Pregnancy Outcomes of Patients with Conization Histories"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5980-2791","authenticated-orcid":false,"given":"Shin","family":"Hashiramoto","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadatsugu","family":"Kinjo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suguru E.","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Varinos, Inc., Aomi, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wataru","family":"Arai","sequence":"additional","affiliation":[{"name":"Varinos, Inc., Aomi, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miho","family":"Shimada","sequence":"additional","affiliation":[{"name":"Varinos, Inc., Aomi, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyota","family":"Ashikawa","sequence":"additional","affiliation":[{"name":"Varinos, Inc., Aomi, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4698-5530","authenticated-orcid":false,"given":"Yoshiyuki","family":"Sakuraba","sequence":"additional","affiliation":[{"name":"Varinos, Inc., Aomi, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oki","family":"Yuji","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nana","family":"Yara","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshino","family":"Kinjyo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukiko","family":"Chinen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Nagai","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Okinawa Prefectural Nanbu Medical Center &amp; 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