Characterization of the urinary microbiota and analysis of the urobiome of hyperglycemic pregnant women

Abstract

The research group "Diabetes and pregnancy - clinical and experimental" in the Botucatu Medical School, has investigated since 2006 the pathophysiology of Gestational Diabetes (GDM) and Mild Gestational Hyperglycemia (MGH) and their relationship with pelvic floor muscle dysfunction (PFMD) and Urinary Incontinence (UI) in clinical and experimental studies. The incidence of pregnancy-specific UI (PS-IU) was greater in women with GDM compared to the non-GDM group, and GDM and DMG were associated. The occurrence of GDM can also be associated with changes in the profiles of the urinary microbiota (urobiome) in pregnant women, as diabetes can change the microenvironment of the urinary tract, leading to long-term UI postpartum. The composition of the microbiome changes during pregnancy, and intestinal microflora and its metabolic activities can participate in several metabolic disorders during pregnancy, such as obesity, diabetes mellitus and GDM. Objectives: The objective of this project is to characterize the urinary microbiota and analyze the urobiome of pregnant women in order to study the relationship between Hyperglycemia and PS-UI. Methods: Subjects (n = 40) will be selected according to the inclusion criteria of this research, and the groups will be formed from the diagnosis of hyperglycemia or GDM plus results of the UI questionnaire for participants who report loss of urine during pregnancy. The urine sample will be collected aseptically from participants who undergo cesarean delivery through a bladder catheter at the time of delivery following a standard protocol, by a responsible physician. The characterization of the urobiota will be performed using a urine culture technique with an expanded detection thresh hold of 10 colony forming units (CFU) / ml. The complete analysis of the urobiome will be performed by sequencing the gene coding for bacterial 16S ribosomal RNA, followed by the analysis of this sequence at the level of genus and species, using a 97% identity limit. Expected results: Studies relating the human microbiota to metabolic diseases such as diabetes have increased in recent years and have shown very relevant results in understanding the physiology of the disease. By identifying the composition and characterization of the urobiome it will be possible to establish novel therapeutic and preventive proposals for PS-IU. (AU)