The objective of this research is to understand whether or not the presence of specific bacteria in urinary microbiome of pregnant women with gestational diabetes mellitus can relate the findings to pregnancy-specific urinary incontinence, in addition to understand how the presence of specifics bacteria can affect or influence other physiological mechanisms.
The study adhered to Botucatu Hospital's protocols, ensuring participants were informed and provided consent through a Free and Informed Consent Form, as mandated by Brazil's National Health Council. Pregnant women from the 24th gestational week at the Prenatal Outpatient Clinic and "Diabetes and Pregnancy" Service were invited to participate. Participants provided demographic and clinical data, only women diagnosed with gestational diabetes mellitus were included and those with urinary incontinence before pregnancy or active infections were excluded. Four groups were formed: non-diabetic pregnant women without urinary incontinence; non-diabetic pregnant women with urinary incontinence; diabetic pregnant women without urinary incontinence and diabetic pregnant women with urinary incontinence. Mid-stream urine samples were collected for urine culture and stored at -20 °C. Standard urine culture techniques identified urobiota and excluded infections, with a detection threshold of 1,000 CFU/ml. Each colony type was counted and identified, with negative results indicating no bacterial growth at the lowest dilution level.
Urine samples were collected from 92 patients, of which 10 were excluded due to positive urine culture results for urinary tract infection (>20,000 CFU/ml). The standard urine culture has a lower bacterial detection capacity compared to the expanded culture to be performed using Maldi-TOF, nevertheless, different genera of bacteria were detected in the urine of the participants. Genera such as Streptococcus and Escherichia were found more frequently among normoglycemic pregnant women, whereas Staphylococcus was more prevalent in pregnant women with gestational diabetes who also presented with pregnancy-specific urinary incontinence. Enterococcus was detected in pregnant women without the presence of pregnancy-specific urinary incontinence.
The environment may contain specific bacteria that may interfere with the onset or maintenance of diabetes mellitus, and may also be related to the presence or severity of pregnancy-specific urinary incontinence.
Detecting the composition of the urobiome and urobiota can guide clinical approaches to prevent or mitigate the incidence of UI during pregnancy.
Hyperglycemia
Urine collection
