Women Of Reproductive Age Research Articles (Page 1)

Polycystic ovary syndrome: antimüllerian hormone and its role in the pathophysiology of the syndrome.

In sub-Saharan Africa (SSA), maternal depression remains a public and social challenge. Available studies from high-income countries suggest that affected women do not constitute one homogeneous group in terms of severity, chronicity, and onset of symptoms. However, few studies have captured the distinct characteristics of such depression patterns in SSA. This study adds to the literature by examining depressive symptoms trajectories and associated factors among reproductive age women in Khwisero, western Kenya. It provides a unique contribution by generating evidence from community-based longitudinal data, using a semiparametric, group-based trajectory modeling to identify heterogenous subgroups of women, each following a distinct pattern of depressive symptom development over time, with their own trajectory pattern and growth parameters.We used data collected from community-based longitudinal household surveys from 2019 to 2023. A total of 257 reproductive age (18-49 years) women were assessed for depressive symptoms using Center for Epidemiological Studies Depression (CES-D) scores and included in the analyses. Latent class growth curve mixture and generalized estimating equation models were used to identify trajectories of depressive symptoms and examine factors associated with each trajectory group, respectively. Bayesian information criterion, the probability of group memberships, average posterior probability, odds of correct classification, and biological plausibility were used to identify and determine the trajectory groups. A p-value of 0.05 was set to examine associations of each trajectory with factors.We found four distinct patterns of depressive symptoms among reproductive age women, namely moderately stable depression (19.8%, Group 1), mildly stable depression (56.8%, Group 2), higher but improving depression (18.6%, Group 3), and unstably high depression (4.8%, Group 4). We also found that reproductive age women who reported better self-rated health status and food security were less likely to experience unstable or moderately increasing depressive symptoms.Reproductive age women exhibit distinct forms of depressive symptoms trajectories, underscoring the need to recognize and address heterogeneity in design, development, and delivery of maternal mental health interventions. These findings also provide deeper insights into the dynamic nature of depressive symptoms in under-researched rural African settings. Further research should focus on examining the effect of time varying factors and understanding potential mechanisms of underlying, proximal, and early life factors, including time varying factors, in a more diversified population using life course model and/or socioecological model. The differential impact of belonging in distinct groups of trajectories on women's future health and their children's health, development, and nutritional outcomes also requires further investigations.

Reproductive tract infections (RTIs) remain a major public health concern among women of reproductive age, but limited evidence exists on their association with knowledge, attitudes, and practices (KAP) in university settings. This study examined the prevalence of RTIs and their relationship with KAP and sociodemographic factors among university-affiliated women. A cross-sectional survey was conducted from October 2023 to March 2024 among 457 women aged 18-48 years at a large comprehensive university in Tianjin, China, including students, faculty, administrative staff, and contracted workers. Participants were recruited through stratified convenience sampling and completed a validated 23-item KAP questionnaire, followed by standardized clinical examination and standardized clinical assessment with targeted laboratory testing. Associations between KAP, sociodemographic characteristics, and RTI prevalence were assessed using descriptive statistics and chi-square tests. The mean KAP score was 50 (SD 14); 34.5% of participants were categorized as low, 46.3% as medium, and 19.0% as high. Overall RTI prevalence was 37.6%, with endometritis (17.7%) and salpingitis (17.2%) most common. Higher KAP levels were inversely associated with RTI prevalence (p < 0.001). Marked gradients were observed by education and expenditure: prevalence was 24.5% among women with a master's degree or above versus 50.8% among college students, and 70.7% among those with monthly expenditure < 2,000 RMB. Institutional affiliation alone did not confer adequate sexual health; persistent occupational and socioeconomic gradients indicate that structural socioeconomic and cultural barriers-rather than educational access per se-drive disparities. Equity-oriented, culturally appropriate, KAP-based interventions and longitudinal evaluation are warranted.

Adequate health literacy (HL) can be particularly important among pregnant women, as it can have an impact on maternal and fetal health. Deliberate intake of folate through food and folic acid supplementation (FAs) is essential for women in reproductive age. Dietary intake of methyl-group donors (MGDs) via maternal nutrition may influence the infant's health and may affect reproductive outcomes through epigenetic mechanisms. The aim of our study was to assess HL in relation to (MGD) intake among pregnant women, and to assess health knowledge as part of health literacy. 124 pregnant women were involved in this cross-sectional study. Data were collected using two validated HL questionnaires, and a food frequency questionnaire (FFQ) to estimate MGD intake. Statistical analyses included the calculation of means, correlation coefficients, and multiple linear regression analysis. The HL of pregnant women was found problematic (50.8% Newest Vital Sign Test, NVS; 46.7% Brief Health Literacy Screening Tool, BRIEF). The estimated intake of dietary folate, methionine, choline and betaine were 264.7 ± 134.6µg/d; 2303 ± 1209mg/d; 248.1 ± 110.8mg/d, and 127.1 ± 65.8mg/d (mean ± standard deviation, SD), respectively. Before pregnancy 58.87% of respondents did not take FAs; during pregnancy, this decreased to 31.45%. Pregnant women did not reach adequate HL. Further evaluation of health literacy, MGD intake, is required to formulate suitable nutritional intake for pregnant women in Hungary. It is suggested that providing better information to pregnant women could improve their adherence to folic acid supplementation recommendations.

BackgroundGestational weight gain (GWG) is a critical factor affecting maternal and fetal health. Excessive GWG increases the risk of complications and contributes to the prevalence of overweight and obesity among women of reproductive age. Despite existing guidelines, many pregnant individuals struggle to manage GWG effectively. Therefore, theory-based and evidence-informed interventions that provide continuous support are urgently needed. Mobile health (mHealth) applications have emerged as promising, cost-effective, and accessible tools for promoting healthy behaviors during pregnancy. This study describes the development of a theory-based mHealth application guided by Social Cognitive Theory (SCT) and the Information-Motivation-Behavioral Skills (IMB) model.ObjectiveThis study aims to present the design and development process of "Gebelikte Kilo Yönetimi" (Gestational Weight Management), a user-centered, evidence-based mHealth application intended to promote healthy nutrition, physical activity, and GWG in line with the Institute of Medicine (IOM) recommendations.MethodsA two-phase, parallel-group, single-blind randomized controlled trial was designed. In Phase 1, the mobile application was developed to support healthy GWG. In Phase 2, its effectiveness in improving adherence to IOM guidelines, promoting healthy eating, and increasing physical activity among pregnant women will be evaluated. The study is registered on ClinicalTrials.gov (NCT06542679).ConclusionsThis mHealth application may offer a scalable, accessible alternative to traditional face-to-face counseling, particularly in settings with limited healthcare access or during public health crises. It holds potential to improve GWG outcomes and support maternal health through digital innovation.

The uric acid (UA) to HDL-cholesterol ratio (UHR) has recently been proposed as a novel marker of cardiometabolic and inflammatory risk. This study aimed to investigate the association between UHR and infertility in U.S. women of reproductive age. We analyzed data from 2447 women aged 18 to 45 years in the National Health and Nutrition Examination Survey (NHANES) 2013 to 2018 cycles. The primary outcome - infertility - was assessed based on self-reported responses from the reproductive health questionnaire of the National Health And Nutrition Examination Survey dataset, and was not clinically validated. UHR was calculated as the ratio of serum UA to HDL-C. Multivariable logistic regression models were constructed to evaluate the association between UHR and infertility risk. Women with infertility had significantly higher mean age, body mass index, UA levels, and log (UHR) values compared to non-infertile participants (all P <.01). In the fully adjusted model, each unit increase in log-transformed UHR was associated with a higher odd of infertility (OR = 2.04, 95% CI: 1.28-3.27, P = .01). Compared with the lowest quartile of UHR, the adjusted odds ratios for infertility were 1.72 (95% CI: 1.09-2.72) for Q2, 1.91 (95% CI: 1.17-3.12) for Q3, and 1.98 (95% CI: 1.15-3.41) for Q4 (P for trend = .017). Subgroup analyses revealed consistent associations across women aged ≥35 years, those living with a partner, never-smokers, women without diabetes mellitus or hypertension, and those with regular menstrual periods or a history of pelvic infection, although no significant interactions were observed. Elevated UHR is associated with an increased risk of infertility in reproductive-aged women, as observed in this cross-sectional analysis. However, due to the study's cross-sectional nature, causality cannot be inferred, and further prospective studies are needed to validate these findings.

Asthma is a growing public health concern in India, but research has largely focused on children or general adult populations, often overlooking women of reproductive age. Prior studies typically use linear models that fail to capture the complex interactions among environmental, socio-demographic, and behavioural risk factors. This study addresses this gap by estimating asthma prevalence in Indian women (15-49 years) and applying machine learning techniques to identify non-linear, high-dimensional predictors using NFHS-5 data. This study analysed NFHS-5 data (2019-2021) using a nationally representative stratified two-stage sampling design. A total of 550,746 women aged 15-49 was included after excluding non-responses to asthma-related questions. Asthma status was self-reported. Bivariate Chi-square tests examined associations with environmental, socio-economic, behavioral, nutritional, and geographic variables. A one-sample t-test assessed dietary score differences. Three machine learning models like Logistic Regression, Random Forest, and XGBoost were developed on a balanced dataset using up-sampling in R (caret package). Model performance was evaluated using AUC and accuracy; key predictors were identified via feature importance and predicted probabilities. Asthma prevalence was 15.4 per 1,000 women (95% CI: 14.9-16.0). Significant associations were observed with environmental (housing, fuel type, sanitation), socio-economic (age, education, caste, religion), behavioral (tobacco, alcohol), and nutritional factors (BMI, dietary score). Random Forest outperformed other models (AUC: 0.912; accuracy: 84.3%; p < 0.001), with dietary score, age, and wealth index as top predictors. Predicted risk was notably higher among older, overweight, less-educated, and urban women (p < 0.05 for all comparisons). Asthma among Indian women is shaped by diverse social, environmental, and behavioral factors. Machine learning, particularly Random Forest, offers valuable predictive insights, highlighting high-risk groups and supporting targeted public health interventions. Not applicable.

Abstract Background Thyroid cancer (TC) exhibits sex-based disparities in incidence, progression, and outcomes, with women of reproductive age exhibiting more favorable prognoses than men. This study investigates sex differences in immune cell dynamics within peripheral blood and the tumor microenvironment (TME) in TC. Methods We performed a prospective study of 27 patients (16 females/11 males) undergoing thyroidectomy for TC or high-risk thyroid nodules. Tissue and blood were collected for immune cell analysis using flow cytometry and spatial transcriptomics. Differential-expression of immune-related genes was assessed with DESeq2, and immune cell frequencies were compared between sexes. Results Males showed higher frequencies of dividing NK cells (9.67 vs 1.29, p&amp;lt;0.001) and Tigit+CD8 T cells (2.34 vs 0.87, p=0.04) in the TME. In contrast, females tended to have higher frequencies of mature NK (2.5 vs 1.08, p=0.07) and CD8 T-cells (0.95 vs 0.68, p=0.09). Spatial transcriptomics revealed that men had reduced expression of HLA-DRB (p=0.001, antigen presentation) in both surrounding normal tissue and the tumor border and a trend for increased LAG3 (p=0.09) in normal tissue compared to women. In the core of the tumor, we observed increased IFNAR1 (p=0.04), CD68 (p=0.04) and B2M (p=0.02) in men vs women. Conclusions Our study reveals significant sex-based differences in immune cell composition and gene expression within the TME of TC. Males exhibit a more immunosuppressive profile, with higher levels of inhibitory immune markers and lower frequencies of functional NK cells. Our findings highlight the importance of incorporating sex-specific immune profiles into development of targeted therapies for advanced TC.

Background: Interactions between calcitonin gene-related peptide (CGRP) levels and ovarian sex hormones, mainly estradiol serum levels, have been described, and hormonal assessment may influence the response to CGRP blocking medication. The aim of our study was to verify possible different response outcomes between women of reproductive age and postmenopausal women treated with monoclonal antibodies targeting CGRP or its receptor (anti-CGRP/R mAbs), considering both traditional outcome parameters (monthly migraine days -MMD- and migraine-related disability) and parameters related to migraine comorbidities (fatigue, subjective sleep quality, psychiatric symptoms, and allodynia), since several studies have shown effects of anti-CGRP/R mAbs on anxiety and depression independently of migraine improvement. Methods: This open-label longitudinal study enrolled 41 women, 22 of childbearing age (median age 43,63 yr) and 19 postmenopausal (median age 60 yr). Clinical parameters and migraine comorbidities were assessed using a headache diary and validated questionnaires (Migraine Disability Assessment Scale – MIDAS, Allodynia Symptom Checklist 12 – ASC-12, Fatigue Severity Scale – FSS, Generalized Anxiety Disorder 7 – GAD-7, Patient Health Questionnaire 9 – PHQ-9, Pittsburgh Sleep Quality Index – PSQI) at baseline (T0) and after 3 (T1) and 6 months (T2) of treatment. Differences in scores between T1 and T0 and between T2 and T0 in the two groups were assessed. Results: There were no significant differences between the two groups at baseline, except for the mean disease duration (27.6 vs. 41.7 years). At T1 and T2, both groups showed a statistically significant reduction in traditional migraine outcome parameters, without significant differences between groups. At T1, a greater reduction in PSQI scores was detected in women of childbearing age compared to postmenopausal women; however, this difference was no longer present at T2 due to improvement in the postmenopausal group. At T2, greater improvements in GAD-7 and PHQ-9 scores were observed in women of reproductive age compared to postmenopausal women. Conclusion: Anti-CGRP/R mAbs resulted effective in treating migraine regardless of the patient's reproductive status. However, our findings suggest that mAbs have a stronger impact on comorbidities related to sleep and psychiatric symptoms in reproductive age women. Subjective sleep quality showed an initial greater benefit in reproductive age women, with a delayed improvement in postmenopausal ones, which may be explained by a slower response in patients with lower CGRP levels.

Low- and middle-income countries are experiencing a rising prevalence of overweight and obesity. These trends are concerning given the health risks associated with overweight and obesity. In this study, we assessed the prevalence and factors associated with overweight and obesity among reproductive aged women in Ghana. This cross-sectional study was conducted using data collected from the 2022 Ghana Demographic and Health Survey which utilized a two-stage stratified cluster sampling design. Frequencies and percentages were used to characterize the sample.Bivariable and multivariable logistic regression analyses accounting for complex survey design were conducted to determine the association between sociodemographic factors and overweight/obesity. The prevalence of overweight and obesity was 50% (95% CI, 48% to 52%). Females who were aged 40-49 years (AOR 2.20; 95% CI, 1.76 to 2.75) and resided in urban areas (AOR 1.35; 95% CI, 1.12 to 1.62) were more likely to be overweight/obese as compared to those aged 20-29 years and resided in rural areas. Women with secondary education (AOR 1.55; 95% CI, 1.22 to 1.96) and belonged to the most affluent wealth quintile (AOR 7.01; 95% CI, 4.46 to 11.02) were more likely to be overweight/obese as compared to those with no education and belonged to the poorest wealth quintile, respectively. Women with 1 child (AOR 1.44; 95% CI, 1.08 to 1.92) and 2 or more children (AOR 1.88; 95% CI, 1.42 to 2.50) were more likely to be overweight/obese as compared to those with none. Living in the Middlebelt region (AOR 2.29; 95% CI, 1.25 to 4.18) or Coastal region (AOR 3.31; 95% CI, 1.39 to 7.90), consumption sugar sweetened beverages and unhealthy sentinel foods (AOR 1.33; 95% CI, 1.13 to 1.57) were all significantly associated with overweight/obesity.eigh CONCLUSION: The prevalence of overweight and obesity is high among females of reproductive age in Ghana. The identified determinants should be considered when developing public health interventions designed to reduce the burden of overweight and obesity.

Vitamin D3 status and seroprevalence of Toxoplasma gondii in reproductive-aged women in Northern Iran.

Prolonged and repetitive exposure to stressors leads to detrimental effects on female reproductive health; this can consequently increase susceptibility to stress and elevate risk of adverse mental health outcomes. Since October 2019, Lebanon has been engulfed in a multipronged crisis, beginning with a severe economic collapse, which was further exacerbated by the COVID-19 pandemic, followed by the catastrophic Beirut Blast in August 2020. These compounding events caused considerable stress, resulting in a substantial mental health burden. We employed a retrospective approach to trace the trend in Anti-Mullerian Hormone levels (the most widely used measure of functional ovarian reserve) in a sample of reproductive-aged Lebanese women in a tertiary healthcare center in Beirut in light of the events described. A retrospective chart review was performed of women aged 18-40 with AMH levels tested between January 2018 and June 2023 [excluding the time period between February 2020 - December 2020] (n = 563). Patients who had AMH levels between January 2018 - January 2020 were included in the 'pre-stressful events' group (n = 254) while those tested between January 2021 - June 2023 were in the 'post-stressful events' group (n = 283). Patient's age, BMI, obstetrical and gynecological history, AMH level, and other relevant lab values were collected. Results were compared using the independent t-test. Overall, this study demonstrated a lower mean AMH level in the post-stressful events group as compared to the pre-stressful events group, but this difference was not statistically significant. Patients with PCOS had a significant decline in the mean AMH level, as did patients with primary infertility. Women with pre-existing reproductive health disorders, such as PCOS and infertility, are more vulnerable to stress and are more likely to experience a decline in AMH level and, by extension, ovarian reserve following stressful experiences.

Menstruation is a natural physiological process in healthy women of reproductive age, often accompanied by physical and psychological symptoms that can impair daily functioning and quality of life. Given the established role of oxidative imbalance in menstrual discomfort, dietary products rich in anti-inflammatory and antioxidant compounds may offer a non-pharmacological approach to symptom management. However, to date, this area remains insufficiently explored in the literature. The aim of this narrative review was to assess the relationship between the consumption of foods with anti-inflammatory potential and the severity of menstrual pain. PubMed, ScienceDirect, and Web of Science were searched from inception to May 2025 using following keywords: “anti-inflammatory products”, “whole grains”, “fish”, “seafood”, “vegetables”, “fruits”, “legumes”, “nuts”, “seeds”, “olive oil”, “fats”, “menstruation”, “primary dysmenorrhea”. Reference lists of included studies were also reviewed manually. Nine relevant studies were identified in the literature review (1 meta-analysis, 2 case-control, and 6 cross-sectional studies). The results showed that whole grains and fish consumption may be inversely associated with menstrual pain, though findings were inconsistent. While one meta-analysis on fruit and vegetable consumption and severity of menstrual pain found no significant association, several other studies reported a protective association with higher/more frequent intake. Evidence on legumes was inconclusive. No studies to date assessed the association between olive oil, nuts, and seeds and menstrual symptoms. Interpretation of findings was limited by methodological heterogeneity, including differences in dietary assessment, symptom measurement tools, and participant characteristics. Preliminary evidence suggests that the anti-inflammatory foods, such as whole grain, vegetables, and fish may help alleviate the severity of menstrual pain, but the current evidence is inconsistent. However, the number of studies published in this area to date is limited and generally of low quality. Therefore, further high-quality research is needed to clarify these associations.

Background: Menstrual migraine is a common condition affecting women of reproductive age, characterized by pulsating, moderate to severe headaches occurring in the two days prior to menstruation, accompanied by nausea, vomiting, photophobia, and phonophobia. Conventional treatment typically involves symptomatic use of NSAIDs and triptans. This study evaluates the efficacy of auricular acupuncture in reducing pain intensity and symptomatic medication use in women with regular menstrual cycles. Methods: Twenty female patients aged between 25 and 45 years with a history of menstrual migraine (present in at least two out of three cycles) and regular menstrual cycles were enrolled. All participants had been using NSAIDs and triptans as needed. Auricular acupuncture was administered using sterile, single-use 0.2×40 mm needles inserted bilaterally at specific points: thalamus, migraine area, brain, sympathetic point, and gonadotropins. Each session lasted 20 minutes, performed approximately every three days, beginning one week before the expected menstruation and continuing until four days after its end. Treatment spanned three consecutive cycles. Results: Patients reported a notable reduction in both migraine-related pain and the need for symptomatic medication. Evaluation using the MIDAS (Migraine Disability Assessment Scale) showed improvement across all subjects: prior to treatment, 13 patients had moderate disability (Grade 3) and 7 had severe disability (Grade 4); post-treatment, all patients demonstrated mild disability (Grade 2) during the three observed cycles. Conclusion: Auricular acupuncture appears to be a safe and well-tolerated intervention for managing menstrual migraine, showing a significant reduction in symptom severity and medication use. These findings suggest its potential as a supportive non-pharmacological treatment in patients with regular menstrual cycles and established migraine patterns. Further controlled studies are warranted to confirm these preliminary outcomes.

Delays in the diagnosis of endometriosis in sub Saharan Africa persist, driven partly by limited access to advanced imaging techniques. Capacity building initiatives focused on ultrasound offer a practical and scalable solution to address this diagnostic gap.

Methamphetamine abuse among women of reproductive age is a growing concern, necessitating investigation of its intrauterine effects on offspring. In this study, we examined the induction of oxidative stress and apoptosis in the ovaries of rat offspring following maternal methamphetamine exposure. Pregnant Wistar rats received methamphetamine (2 mg/kg or 5 mg/kg) from gestational day 10 until delivery. Control rats received 0.9% saline (1 mL/kg) on the same schedule. Female offspring were raised to puberty and their ovaries were examined, compared to controls. Protein expression levels of FASL and TRAIL were assessed by immunohistochemistry, and antioxidant enzyme levels (superoxide dismutase, SOD) and oxidative stress marker levels (malondialdehyde, MDA) were evaluated by ELISA1. Histological examination of the ovaries was performed using H&E staining. Maternal methamphetamine treatment significantly increased ovarian FASL and TRAIL protein expression in the pubertal offspring (p ≤ 0.001). In utero methamphetamine exposure led to a dose-dependent increase in ovarian MDA levels and a corresponding decrease in SOD activity (p ≤ 0.05). Histologically, exposed offspring showed a reduction in the number of primordial, primary, secondary, and Graafian follicles, as well as a reduction in corpora lutea, compared to controls (p < 0.05). Conversely, the number of atretic follicles increased significantly in a dose-dependent manner (p < 0.05). Prenatal methamphetamine exposure induces oxidative stress and promotes apoptosis in the ovaries of offspring, leading to reduced ovarian follicle reserves. These findings raise concerns that methamphetamine use during pregnancy may impair female reproductive health in offspring.

Objectives: Pelvic organ prolapse (POP) disorders are a significant problem with a society-wide dimension, affecting the quality of life of many women around the world. The purpose of this study is to assess the influence of sociodemographic factors on health-preserving behaviors in relation to pelvic organ prolapse in women of reproductive age. Method: The survey was conducted using a questionnaire made available electronically and a paper questionnaire distributed to female patients of the Gynecology and Obstetrics Clinical Hospital of the Karol Marcinkowski Medical University in Poznan. In total, 160 women aged 15–49 years voluntarily participated in the study. The distribution of variables was assessed using the Shapiro–Wilk test. The Mann–Whitney U and Kruskal–Wallis ANOVA tests were used for comparisons between groups. Comparisons between assessment scores and self-assessment of knowledge were made using Wilcoxon’s paired rank order test and the Chi2 NW (highest reliability) test. A p-value &lt; 0.05 was considered statistically significant. Results: The level of knowledge about POP prevention and conservative treatment methods is low. The group with a higher level of knowledge was characterized by younger age, higher education, and living in areas with a large population. Conclusions: The results suggest only a partial understanding of the topic of pelvic organ prolapse, while lacking full awareness of prevention.

Abstract Uterine fibroids are the most common, benign, monoclonal pelvic tumors in women of reproductive age and as many as 1 in 20 women aged between 30 and 49 years consult their general practitioners each year because of heavy menstrual bleeding (HMB) necessitating the use of complementary therapies like homeopathy. This study investigates the use of homeopathic medicine Vinca minor mother tincture in 31 patients of uterine fibroid with HMB. The primary objective was to study the effect of empirically selected Vinca minor in controlling HMB due to uterine fibroids, assessed by Higham pictorial blood assessment chart (HPBAC) after 6 months of intervention. The secondary objective was to compare the Uterine Fibroid Symptom and Health-Related Quality of Life (UFS-QOL) after 6 months of intervention. A pilot study was conducted at the out-patient department of Homoeopathy Drug Research Institute, Lucknow. The primary outcome was to assess changes in HPBAC score over 6 months and the secondary outcome was to assess the changes in UFSQOL over 6 months of treatment. Data were analyzed as per protocol by paired t-test and repeated measure analysis of variance overall. Out of 54 patients screened, 33 patients were enrolled in the study and Vinca minor mother tincture was administered in every case for a period of 6 months. There was a statistically significant reduction in the heavy bleeding (96.7%) as assessed through the HPBAC score (p &lt; 0.05). Significant improvement was also found in the quality of life of the patients. This study has shown positive results in reducing the heavy bleeding and improving the quality of life. More work is needed in a controlled setting for evaluating its potential.

An increase of group B Streptococcus (GBS) colonization in pregnant women with a parallel rise in neonatal and infant infections, were observed in Korea. We characterized antimicrobial resistance (AMR) and molecular features of GBS isolates from reproductive-aged women between 1994-2000 and 2017-2022. We collected 246 GBS isolates, 37 during 1994-2000 and 209 during 2017-2022, from cervical and/or anorectal swabs at three institutions. Antimicrobial susceptibility was tested using the MicroScan MicroSTREP Plus Panel (Beckman Coulter, Brea, CA, USA). Sequence types (STs), clonal complexes (CCs), cps genotypes by serotypes, and AMR genes were identified using whole-genome sequencing on the NovaSeq 6000 system (Illumina, San Diego, CA, USA). During 1994-2000, CC19 was predominant (35.1%, 13/37), whereas during 2017-2022, CC1 became the most common (35.4%, 74/209). cps genotype VIII, previously limited to one ST1 isolate, appeared in 32 ST2 isolates (P =0.037). All isolates remained susceptible to β-lactams and vancomycin. Tetracycline resistance decreased from 97.3% to 60.8% (P <0.001), with tetM prevalence decreasing from 91.7% to 72.4% (P <0.001) and tetO prevalence increasing from 2.8% to 29.9% (P =0.017). Levofloxacin resistance increased from 0% to 23.4% (P =0.001), with 98.0% of resistant isolates carrying both gyrA and parC. The number of resistance profiles increased from six to 16, including 11 newly identified patterns, covering 81.8% of levofloxacin resistant isolates. The acquisition of diverse resistance genes has expanded AMR profiles in colonized GBS, emphasizing the need for sustained nationwide surveillance.

Background Bacterial vaginosis (BV) is the most common vaginal infection in reproductive-age women. It is associated with adverse pregnancy complications, such as preterm birth and low birth weight, in addition to an increased risk of acquisition of HIV and sexually transmitted infections. BV is characterized by a vaginal dysbiosis, involving loss of protective Lactobacillus species (including L. crispatus ) and overgrowth of facultative and strict anaerobic bacteria, with Gardnerella species playing a predominant role. However, despite extensive research on BV pathogenesis, its etiology remains unclear, and the sequence of events leading to the displacement of lactobacilli by anaerobic bacteria in women has not yet been fully elucidated. Until 2019, all bacteria belonging to the Gardnerella genus were considered part of the species G. vaginalis . However, it is now recognized that different Gardnerella species exist, each with varying virulence potentials. Recent data have shown that multiple subgroups of Gardnerella spp. are frequently detected simultaneously in the vaginal microbiota of women with BV. With this in mind, we aimed to test the hypothesis that different combinations of known Gardnerella species, isolated from the vaginal microbiota of women with BV, have an enhanced ability to compete against Lactobacillus crispatus , pre-adhered to HeLa cells, thereby facilitating the early stages of BV development. Methods Adhesion assays of dual combinations of Gardnerella spp. ( G. vaginalis , G. leopoldii , G. swidsinskii , G. piotii ) were performed on an in vitro model of HeLa cells, covered with and without L. crispatus . Quantification of the species used in our assays was subsequently performed using quantitative polymerase chain reaction (qPCR). Results Our results revealed synergy between different Gardnerella spp., demonstrating their ability to overcome the presumed protective effect of L. crispatus , thereby creating favorable conditions for the development of a polymicrobial biofilm characteristic of BV. The combination of G. vaginalis and G. leopoldii showed the greatest synergistic effect on initial adhesion to HeLa cells while the combination of G. leopoldii and G. swidsinskii had the greatest ability to reduce L. crispatus colonization. Conclusions Although this in vitro study does not unequivocally prove that BV is initiated by the disruption of normal vaginal microbiota by Gardnerella spp., it strongly supports this possibility, contributing to a better understanding of BV etiology.