{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T16:35:04Z","timestamp":1790094904415,"version":"4.0.1"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T00:00:00Z","timestamp":1625616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:p>The features of the vaginal microbiota (VM) community can reflect health status, and they could become new biomarkers for disease diagnosis. During pregnancy, domination of bacteria of the genus <jats:italic>Lactobacillus<\/jats:italic> in the VM community is regarded as a keystone because they stabilize the VM by producing antimicrobial compounds and competing adhesion. An altered VM composition provides a marker for adverse pregnancy outcomes. This nested case\u2013control study aimed to characterize the VM in women with a tubal pregnancy (TP) presenting with pain and\/or uterine bleeding in early pregnancy. Chinese women with a symptomatic early pregnancy of unknown location were the study cohort. 16S rDNA gene-sequencing of V3\u2013V4 variable regions was done to assess the diversity, structures, taxonomic biomarkers, and classification of the VM community. The primary outcome was the location of the early pregnancy. The VM community in women with a TP showed higher diversity (PD-whole-tree, median: 8.26 <jats:italic>vs<\/jats:italic>. 7.08, <jats:italic>P<\/jats:italic> = 0.047; Shannon Diversity Index, median: 1.43 <jats:italic>vs<\/jats:italic> 0.99, <jats:italic>P<\/jats:italic> = 0.03) and showed different structures to those in women with an intrauterine pregnancy (IUP) (<jats:italic>R<\/jats:italic> = 0.23, <jats:italic>P<\/jats:italic> &amp;lt; 0.01). Bacteria of the genus <jats:italic>Lactobacillus<\/jats:italic> were significantly enriched in the IUP group, whereas bacteria of the genera <jats:italic>Gardnerella<\/jats:italic> and <jats:italic>Prevotella<\/jats:italic> were significantly enriched in the TP group. <jats:italic>Lactobacillus<\/jats:italic> abundance could be used to classify the pregnancy location (AUC = 0.81). Non-<jats:italic>Lactobacillus<\/jats:italic>-dominated microbiota (\u2264 0.85% <jats:italic>Lactobacillus<\/jats:italic>) was significantly associated with a TP (adjusted odds ratio: 4.42, 95% confidence interval: 1.33 to 14.71, <jats:italic>P<\/jats:italic> = 0.02). In conclusion, among women with a symptomatic early pregnancy, a higher diversity and lower abundance of <jats:italic>Lactobacillus<\/jats:italic> in the VM is associated with a TP.<\/jats:p>","DOI":"10.3389\/fcimb.2021.659505","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T17:24:07Z","timestamp":1625678647000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Non-Lactobacillus-Dominated Vaginal Microbiota Is Associated With a Tubal Pregnancy in Symptomatic Chinese Women in the Early Stage of Pregnancy: A Nested Case\u2013Control Study"],"prefix":"10.3389","volume":"11","author":[{"given":"Xiao-Feng","family":"Ruan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying-Xuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Rong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang-Fang","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan-Xi","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Jing","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song-Ping","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gao-Pi","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e91","DOI":"10.1097\/AOG.0000000000002560","article-title":"ACOG Practice Bulletin No. 193: Tubal Ectopic Pregnancy","volume":"131","year":"2018","journal-title":"Obstet. 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