Low abundance of Lactobacillus, high abundance of G. vaginalis, increased diversity of CST-IV with L. iners dominance, high levels of S. amnii, Prevotella, Atopobium vaginane, Megasphaera
Higher abundance of Bacteroidetes, Veillonella, Klebsiella, Escherichia-Shigella, Enterobacter, Enterococcus, high levels of fungal flora like Candida and Saccharomyces
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Ravel J, Gajer P, Abdo Z, Schneider GM, Koenig SSK, McCulle SL, et al. Vaginal microbiome of reproductive-age women.Proc Natl Acad Sci U S A. 2011;108 Suppl 1:4680–7. [DOI] [PubMed] [PMC]
Aroutcheva A, Gariti D, Simon M, Shott S, Faro J, Simoes JA, et al. Defense factors of vaginal lactobacilli.Am J Obstet Gynecol. 2001;185:375–9. [DOI] [PubMed]
Eschenbach DA, Davick PR, Williams BL, Klebanoff SJ, Young-Smith K, Critchlow CM, et al. Prevalence of hydrogen peroxide-producing Lactobacillus species in normal women and women with bacterial vaginosis.J Clin Microbiol. 1989;27:251–6. [DOI] [PubMed] [PMC]
Witkin SS, Mendes-Soares H, Linhares IM, Jayaram A, Ledger WJ, Forney LJ. Influence of vaginal bacteria and D- and L-lactic acid isomers on vaginal extracellular matrix metalloproteinase inducer: implications for protection against upper genital tract infections.mBio. 2013;4:e00460–13. [DOI] [PubMed] [PMC]
O’Hanlon DE, Moench TR, Cone RA. Vaginal pH and microbicidal lactic acid when lactobacilli dominate the microbiota.PLoS One. 2013;8:e80074. [DOI] [PubMed] [PMC]
O’Hanlon DE, Moench TR, Cone RA. In vaginal fluid, bacteria associated with bacterial vaginosis can be suppressed with lactic acid but not hydrogen peroxide.BMC Infect Dis. 2011;11:200. [DOI] [PubMed] [PMC]
Selle K, Klaenhammer TR. Genomic and phenotypic evidence for probiotic influences of Lactobacillus gasseri on human health.FEMS Microbiol Rev. 2013;37:915–35. [DOI] [PubMed]
Zárate G, Nader-Macias ME. Influence of probiotic vaginal lactobacilli on in vitro adhesion of urogenital pathogens to vaginal epithelial cells.Lett Appl Microbiol. 2006;43:174–80. [DOI] [PubMed]
Zárate G, Santos V, Nader-Macias ME. Protective effect of vaginal Lactobacillus paracasei CRL 1289 against urogenital infection produced by Staphylococcus aureus in a mouse animal model.Infect Dis Obstet Gynecol. 2009;2009:48358. [DOI] [PubMed] [PMC]
Atassi F, Brassart D, Grob P, Graf F, Servin AL. Lactobacillus strains isolated from the vaginal microbiota of healthy women inhibit Prevotella bivia and Gardnerella vaginalis in coculture and cell culture.FEMS Immunol Med Microbiol. 2006;48:424–32. [DOI] [PubMed]
Boris S, Suárez JE, Vázquez F, Barbés C. Adherence of human vaginal lactobacilli to vaginal epithelial cells and interaction with uropathogens.Infect Immun. 1998;66:1985–9. [DOI] [PubMed] [PMC]
Kaewsrichan J, Peeyananjarassri K, Kongprasertkit J. Selection and identification of anaerobic lactobacilli producing inhibitory compounds against vaginal pathogens.FEMS Immunol Med Microbiol. 2006;48:75–83. [DOI] [PubMed]
Osset J, Bartolomé RM, García E, Andreu A. Assessment of the capacity of Lactobacillus to inhibit the growth of uropathogens and block their adhesion to vaginal epithelial cells.J Infect Dis. 2001;183:485–91. [DOI] [PubMed]
Spurbeck RR, Arvidson CG. Inhibition of Neisseria gonorrhoeae epithelial cell interactions by vaginal Lactobacillus species.Infect Immun. 2008;76:3124–30. [DOI] [PubMed] [PMC]
Auriemma RS, Scairati R, Del Vecchio G, Liccardi A, Verde N, Pirchio R, et al. The Vaginal Microbiome: A Long Urogenital Colonization Throughout Woman Life.Front Cell Infect Microbiol. 2021;11:686167. [DOI] [PubMed] [PMC]
Barrientos-Durán A, Fuentes-López A, de Salazar A, Plaza-Díaz J, García F. Reviewing the Composition of Vaginal Microbiota: Inclusion of Nutrition and Probiotic Factors in the Maintenance of Eubiosis.Nutrients. 2020;12:419. [DOI] [PubMed] [PMC]
Brotman RM, Shardell MD, Gajer P, Fadrosh D, Chang K, Silver MI, et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy.Menopause. 2018;25:1321–30. [DOI] [PubMed]
Muhleisen AL, Herbst-Kralovetz MM. Menopause and the vaginal microbiome.Maturitas. 2016;91:42–50. [DOI] [PubMed]
Heinemann C, Reid G. Vaginal microbial diversity among postmenopausal women with and without hormone replacement therapy.Can J Microbiol. 2005;51:777–81. [DOI] [PubMed]
Pabich WL, Fihn SD, Stamm WE, Scholes D, Boyko EJ, Gupta K. Prevalence and determinants of vaginal flora alterations in postmenopausal women.J Infect Dis. 2003;188:1054–8. [DOI] [PubMed]
Chaban B, Links MG, Jayaprakash TP, Wagner EC, Bourque DK, Lohn Z, et al. Characterization of the vaginal microbiota of healthy Canadian women through the menstrual cycle.Microbiome. 2014;2:23. [DOI] [PubMed] [PMC]
Song SD, Acharya KD, Zhu JE, Deveney CM, Walther-Antonio MRS, Tetel MJ, et al. Daily Vaginal Microbiota Fluctuations Associated with Natural Hormonal Cycle, Contraceptives, Diet, and Exercise.mSphere. 2020;5:e00593–20. [DOI] [PubMed] [PMC]
Srinivasan S, Liu C, Mitchell CM, Fiedler TL, Thomas KK, Agnew KJ, et al. Temporal variability of human vaginal bacteria and relationship with bacterial vaginosis.PLoS One. 2010;5:e10197. [DOI] [PubMed] [PMC]
Eschenbach DA, Thwin SS, Patton DL, Hooton TM, Stapleton AE, Agnew K, et al. Influence of the normal menstrual cycle on vaginal tissue, discharge, and microflora.Clin Infect Dis. 2000;30:901–7. [DOI] [PubMed]
DiGiulio DB, Callahan BJ, McMurdie PJ, Costello EK, Lyell DJ, Robaczewska A, et al. Temporal and spatial variation of the human microbiota during pregnancy.Proc Natl Acad Sci U S A. 2015;112:11060–5. [DOI] [PubMed] [PMC]
Aagaard K, Riehle K, Ma J, Segata N, Mistretta TA, Coarfa C, et al. A metagenomic approach to characterization of the vaginal microbiome signature in pregnancy.PLoS One. 2012;7:e36466. [DOI] [PubMed] [PMC]
Alhabardi SM, Edris S, Bahieldin A, Al-Hindi RR. The composition and stability of the vaginal microbiome of healthy women.J Pak Med Assoc. 2021;71:2045–51. [DOI] [PubMed]
MacIntyre DA, Chandiramani M, Lee YS, Kindinger L, Smith A, Angelopoulos N, et al. The vaginal microbiome during pregnancy and the postpartum period in a European population.Sci Rep. 2015;5:8988. [DOI] [PubMed] [PMC]
Fettweis JM, Brooks JP, Serrano MG, Sheth NU, Girerd PH, Edwards DJ, et al.; The Vaginal Microbiome Consortium; Jefferson KK, Buck GA. Differences in vaginal microbiome in African American women versus women of European ancestry.Microbiology (Reading). 2014;160:2272–82. [DOI] [PubMed] [PMC]
Zhou X, Hansmann MA, Davis CC, Suzuki H, Brown CJ, Schütte U, et al. The vaginal bacterial communities of Japanese women resemble those of women in other racial groups.FEMS Immunol Med Microbiol. 2010;58:169–81. [DOI] [PubMed] [PMC]
Zhou X, Brown CJ, Abdo Z, Davis CC, Hansmann MA, Joyce P, et al. Differences in the composition of vaginal microbial communities found in healthy Caucasian and black women.ISME J. 2007;1:121–33. [DOI] [PubMed]
Xiao BB, Liao QP. Analysis of diversity of vaginal microbiota in healthy Chinese women by using DNA-fingerprinting.Beijing Da Xue Xue Bao Yi Xue Ban. 2012;44:281–7. [PubMed]
Mirmonsef P, Hotton AL, Gilbert D, Burgad D, Landay A, Weber KM, et al. Free glycogen in vaginal fluids is associated with Lactobacillus colonization and low vaginal pH.PLoS One. 2014;9:e102467. [DOI] [PubMed] [PMC]
Thoma ME, Klebanoff MA, Rovner AJ, Nansel TR, Neggers Y, Andrews WW, et al. Bacterial vaginosis is associated with variation in dietary indices.J Nutr. 2011;141:1698–704. [DOI] [PubMed] [PMC]
Hensel KJ, Randis TM, Gelber SE, Ratner AJ. Pregnancy-specific association of vitamin D deficiency and bacterial vaginosis.Am J Obstet Gynecol. 2011;204:41.e1–9. [DOI] [PubMed]
Bodnar LM, Krohn MA, Simhan HN. Maternal vitamin D deficiency is associated with bacterial vaginosis in the first trimester of pregnancy.J Nutr. 2009;139:1157–61. [DOI] [PubMed] [PMC]
Dunlop AL, Taylor RN, Tangpricha V, Fortunato S, Menon R. Maternal vitamin D, folate, and polyunsaturated fatty acid status and bacterial vaginosis during pregnancy.Infect Dis Obstet Gynecol. 2011;2011:216217. [DOI] [PubMed] [PMC]
Neggers YH, Nansel TR, Andrews WW, Schwebke JR, Yu KF, Goldenberg RL, et al. Dietary intake of selected nutrients affects bacterial vaginosis in women.J Nutr. 2007;137:2128–33. [DOI] [PubMed] [PMC]
Raglan O, MacIntyre DA, Mitra A, Lee YS, Smith A, Assi N, et al. The association between obesity and weight loss after bariatric surgery on the vaginal microbiota.Microbiome. 2021;9:124. [DOI] [PubMed] [PMC]
Daubert E, Weber KM, French AL, Seidman D, Michel K, Gustafson D, et al. Obesity is associated with lower bacterial vaginosis prevalence in menopausal but not pre-menopausal women in a retrospective analysis of the Women's Interagency HIV Study.PLoS One. 2021;16:e0248136. [DOI] [PubMed] [PMC]
Amabebe E, Anumba DOC. Psychosocial Stress, Cortisol Levels, and Maintenance of Vaginal Health.Front Endocrinol (Lausanne). 2018;9:568. [DOI] [PubMed] [PMC]
Culhane JF, Rauh V, McCollum KF, Hogan VK, Agnew K, Wadhwa PD. Maternal stress is associated with bacterial vaginosis in human pregnancy.Matern Child Health J. 2001;5:127–34. [DOI] [PubMed]
Nansel TR, Riggs MA, Yu KF, Andrews WW, Schwebke JR, Klebanoff MA. The association of psychosocial stress and bacterial vaginosis in a longitudinal cohort.Am J Obstet Gynecol. 2006;194:381–6. [DOI] [PubMed] [PMC]
Pybus V, Onderdonk AB. A commensal symbiosis between Prevotella bivia and Peptostreptococcus anaerobius involves amino acids: potential significance to the pathogenesis of bacterial vaginosis.FEMS Immunol Med Microbiol. 1998;22:317–27. [DOI] [PubMed]
Brown MA, Magee LA, Kenny LC, Karumanchi SA, McCarthy FP, Saito S, et al.; International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertensive Disorders of Pregnancy: ISSHP Classification, Diagnosis, and Management Recommendations for International Practice.Hypertension. 2018;72:24–43. [DOI] [PubMed]
Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations.Am J Med. 1983;74:14–22. [DOI] [PubMed]
Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation.J Clin Microbiol. 1991;29:297–301. [DOI] [PubMed] [PMC]
Piot P, van Dyck E, Goodfellow M, Falkow S. A taxonomic study of Gardnerella vaginalis (Haemophilus vaginalis) Gardner and Dukes 1955.J Gen Microbiol. 1980;119:373–96. [DOI] [PubMed]
Garcia EM, Kraskauskiene V, Koblinski JE, Jefferson KK. Interaction of Gardnerella vaginalis and Vaginolysin with the Apical versus Basolateral Face of a Three-Dimensional Model of Vaginal Epithelium.Infect Immun. 2019;87:e00646–18. [DOI] [PubMed] [PMC]
Swidsinski A, Mendling W, Loening-Baucke V, Swidsinski S, Dörffel Y, Scholze J, et al. An adherent Gardnerella vaginalis biofilm persists on the vaginal epithelium after standard therapy with oral metronidazole.Am J Obstet Gynecol. 2008;198:97.e1–6. [DOI] [PubMed]
Kyongo JK, Crucitti T, Menten J, Hardy L, Cools P, Michiels J, et al. Cross-Sectional Analysis of Selected Genital Tract Immunological Markers and Molecular Vaginal Microbiota in Sub-Saharan African Women, with Relevance to HIV Risk and Prevention.Clin Vaccine Immunol. 2015;22:526–38. [DOI] [PubMed] [PMC]
Usyk M, Schlecht NF, Pickering S, Williams L, Sollecito CC, Gradissimo A, et al.; Costa Rica HPV Vaccine Trial (CVT) Group; Burk RD. molBV reveals immune landscape of bacterial vaginosis and predicts human papillomavirus infection natural history.Nat Commun. 2022;13:233. [DOI] [PubMed] [PMC]
Hemalatha R, Ramalaxmi BA, KrishnaSwetha G, Kumar PU, Rao DM, Balakrishna N, et al. Cervicovaginal inflammatory cytokines and sphingomyelinase in women with and without bacterial vaginosis.Am J Med Sci. 2012;344:35–9. [DOI] [PubMed]
Al-Memar M, Bobdiwala S, Fourie H, Mannino R, Lee YS, Smith A, et al. The association between vaginal bacterial composition and miscarriage: a nested case-control study.BJOG. 2020;127:264–74. [DOI] [PubMed] [PMC]
Chang DH, Shin J, Rhee MS, Park KR, Cho BK, Lee SK, et al. Vaginal Microbiota Profiles of Native Korean Women and Associations with High-Risk Pregnancy.J Microbiol Biotechnol. 2020;30:248–58. [DOI] [PubMed] [PMC]
Gryaznova M, Kozarenko O, Smirnova Y, Burakova I, Syromyatnikov M, Maslov A, et al. Cervical and Vaginal Microbiomes in Early Miscarriages and Ongoing Pregnancy with and without Dydrogesterone Usage.Int J Mol Sci. 2023;24:13836. [DOI] [PubMed] [PMC]
Liu FT, Yang S, Yang Z, Zhou P, Peng T, Yin J, et al. An Altered Microbiota in the Lower and Upper Female Reproductive Tract of Women with Recurrent Spontaneous Abortion.Microbiol Spectr. 2022;10:e0046222. [DOI] [PubMed] [PMC]
Caliskan CS, Yurtcu N, Celik S, Sezer O, Kilic SS, Cetin A. Derangements of vaginal and cervical canal microbiota determined with real-time PCR in women with recurrent miscarriages.J Obstet Gynaecol. 2022;42:2105–14. [DOI] [PubMed]
Fan T, Zhong XM, Wei XC, Miao ZL, Luo SY, Cheng H, et al. The alteration and potential relationship of vaginal microbiota and chemokines for unexplained recurrent spontaneous abortion.Medicine (Baltimore). 2020;99:e23558. [DOI] [PubMed] [PMC]
Jiao X, Zhang L, Du D, Wang L, Song Q, Liu S. Alteration of vaginal microbiota in patients with recurrent miscarriage.J Obstet Gynaecol. 2022;42:248–55. [DOI] [PubMed]
Brown RG, Marchesi JR, Lee YS, Smith A, Lehne B, Kindinger LM, et al. Vaginal dysbiosis increases risk of preterm fetal membrane rupture, neonatal sepsis and is exacerbated by erythromycin.BMC Med. 2018;16:9. [DOI] [PubMed] [PMC]
Callahan BJ, DiGiulio DB, Goltsman DSA, Sun CL, Costello EK, Jeganathan P, et al. Replication and refinement of a vaginal microbial signature of preterm birth in two racially distinct cohorts of US women.Proc Natl Acad Sci U S A. 2017;114:9966–71. [DOI] [PubMed] [PMC]
de Freitas AS, Dobbler PCT, Mai V, Procianoy RS, Silveira RC, Corso AL, et al. Defining microbial biomarkers for risk of preterm labor.Braz J Microbiol. 2020;51:151–9. [DOI] [PubMed] [PMC]
Liao J, Shenhav L, Urban JA, Serrano M, Zhu B, Buck GA, et al. Microdiversity of the vaginal microbiome is associated with preterm birth.Nat Commun. 2023;14:4997. [DOI] [PubMed] [PMC]
Cortez RV, Taddei CR, Sparvoli LG, Ângelo AGS, Padilha M, Mattar R, et al. Microbiome and its relation to gestational diabetes.Endocrine. 2019;64:254–64. [DOI] [PubMed]
Zheng NN, Guo XC, Lv W, Chen XX, Feng GF. Characterization of the vaginal fungal flora in pregnant diabetic women by 18S rRNA sequencing.Eur J Clin Microbiol Infect Dis. 2013;32:1031–40. [DOI] [PubMed]
Ma Y, Li Y, Liu Y, Cao L, Han X, Gao S, et al. Vaginal Microbiome Dysbiosis is Associated with the Different Cervical Disease Status.J Microbiol. 2023;61:423–32. [DOI] [PubMed]
Lin CY, Lin CY, Yeh YM, Yang LY, Lee Y, Chao AY, et al. Severe preeclampsia is associated with a higher relative abundance of Prevotella bivia in the vaginal microbiota.Sci Rep. 2020;10:18249. [DOI] [PubMed] [PMC]
Tomimatsu T, Mimura K, Matsuzaki S, Endo M, Kumasawa K, Kimura T. Preeclampsia: Maternal Systemic Vascular Disorder Caused by Generalized Endothelial Dysfunction Due to Placental Antiangiogenic Factors.Int J Mol Sci. 2019;20:4246. [DOI] [PubMed] [PMC]
McGinnis R, Steinthorsdottir V, Williams NO, Thorleifsson G, Shooter S, Hjartardottir S, et al.; FINNPEC Consortium; GOPEC Consortium; Dominiczak AF, Gjessing HK, Casas JP, Dudbridge F, Walker JJ, Pipkin FB, et al. Variants in the fetal genome near FLT1 are associated with risk of preeclampsia.Nat Genet. 2017;49:1255–60. [DOI] [PubMed]
Huang QT, Wang SS, Zhang M, Huang LP, Tian JW, Yu YH, et al. Advanced oxidation protein products enhances soluble Fms-like tyrosine kinase 1 expression in trophoblasts: a possible link between oxidative stress and preeclampsia.Placenta. 2013;34:949–52. [DOI] [PubMed]
Rudensky AY. Regulatory T cells and Foxp3.Immunol Rev. 2011;241:260–8. [DOI] [PubMed] [PMC]
Erlebacher A. Mechanisms of T cell tolerance towards the allogeneic fetus.Nat Rev Immunol. 2013;13:23–33. [DOI] [PubMed]
Eghbal-Fard S, Yousefi M, Heydarlou H, Ahmadi M, Taghavi S, Movasaghpour A, et al. The imbalance of Th17/Treg axis involved in the pathogenesis of preeclampsia.J Cell Physiol. 2019;234:5106–16. [DOI] [PubMed]
Cao W, Wang X, Chen T, Zhu H, Xu W, Zhao S, et al. The Expression of Notch/Notch Ligand, IL-35, IL-17, and Th17/Treg in Preeclampsia.Dis Markers. 2015;2015:316182. [DOI] [PubMed] [PMC]
Zhang Z, Liu H, Shi Y, Xu N, Wang Y, Li A, et al. Increased circulating Th22 cells correlated with Th17 cells in patients with severe preeclampsia.Hypertens Pregnancy. 2017;36:100–7. [DOI] [PubMed]
Santner-Nanan B, Peek MJ, Khanam R, Richarts L, Zhu E, Fazekas de St Groth B, et al. Systemic increase in the ratio between Foxp3+ and IL-17-producing CD4+ T cells in healthy pregnancy but not in preeclampsia.J Immunol. 2009;183:7023–30. [DOI] [PubMed]
Darmochwal-Kolarz D, Kludka-Sternik M, Tabarkiewicz J, Kolarz B, Rolinski J, Leszczynska-Gorzelak B, et al. The predominance of Th17 lymphocytes and decreased number and function of Treg cells in preeclampsia.J Reprod Immunol. 2012;93:75–81. [DOI] [PubMed]
Wang TT, Nestel FP, Bourdeau V, Nagai Y, Wang Q, Liao J, et al. Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression.J Immunol. 2004;173:2909–12. [DOI] [PubMed]
Yuk JM, Shin DM, Lee HM, Yang CS, Jin HS, Kim KK, et al. Vitamin D3 induces autophagy in human monocytes/macrophages via cathelicidin.Cell Host Microbe. 2009;6:231–43. [DOI] [PubMed]
Khoo AL, Chai LYA, Koenen HJPM, Oosting M, Steinmeyer A, Zuegel U, et al. Vitamin D(3) down-regulates proinflammatory cytokine response to Mycobacterium tuberculosis through pattern recognition receptors while inducing protective cathelicidin production.Cytokine. 2011;55:294–300. [DOI] [PubMed]
Dankers W, Davelaar N, van Hamburg JP, van de Peppel J, Colin EM, Lubberts E. Human Memory Th17 Cell Populations Change Into Anti-inflammatory Cells With Regulatory Capacity Upon Exposure to Active Vitamin D.Front Immunol. 2019;10:1504. [DOI] [PubMed] [PMC]
Kang SW, Kim SH, Lee N, Lee WW, Hwang KA, Shin MS, et al. 1,25-Dihyroxyvitamin D3 promotes FOXP3 expression via binding to vitamin D response elements in its conserved noncoding sequence region.J Immunol. 2012;188:5276–82. [DOI] [PubMed] [PMC]
Jefferson KK, Parikh HI, Garcia EM, Edwards DJ, Serrano MG, Hewison M, et al. Relationship between vitamin D status and the vaginal microbiome during pregnancy.J Perinatol. 2019;39:824–36. [DOI] [PubMed] [PMC]
Rad P, Tadayon M, Abbaspour M, Latifi SM, Rashidi I, Delaviz H. The effect of vitamin D on vaginal atrophy in postmenopausal women.Iran J Nurs Midwifery Res. 2015;20:211–5. [PubMed] [PMC]
Mojtahedi SF, Mohammadzadeh A, Mohammadzadeh F, Shahri JJ, Bahri N. Association between bacterial vaginosis and 25-Hydroxy vitamin D: a case-control study.BMC Infect Dis. 2023;23:208. [DOI] [PubMed] [PMC]
Taheri M, Baheiraei A, Foroushani AR, Nikmanesh B, Modarres M. Treatment of vitamin D deficiency is an effective method in the elimination of asymptomatic bacterial vaginosis: A placebo-controlled randomized clinical trial.Indian J Med Res. 2015;141:799–806. [DOI] [PubMed] [PMC]
Ma L, Zhang Z, Li L, Zhang L, Lin Z, Qin H. Vitamin D deficiency increases the risk of bacterial vaginosis during pregnancy: Evidence from a meta-analysis based on observational studies.Front Nutr. 2022;9:1016592. [DOI] [PubMed] [PMC]
Liu M, Xiang J, Zhang M, Zhang Y, Liu J. Non-linear association between serum vitamin D and bacterial vaginosis in U.S. women: analysis from NHANES 2001–2004.Front Nutr. 2025;12:1606246. [DOI] [PubMed] [PMC]
Bodnar LM, Catov JM, Simhan HN, Holick MF, Powers RW, Roberts JM. Maternal vitamin D deficiency increases the risk of preeclampsia.J Clin Endocrinol Metab. 2007;92:3517–22. [DOI] [PubMed] [PMC]
AlSubai A, Baqai MH, Agha H, Shankarlal N, Javaid SS, Jesrani EK, et al. Vitamin D and preeclampsia: A systematic review and meta-analysis.SAGE Open Med. 2023;11:20503121231212093. [DOI] [PubMed] [PMC]
Das B, Singhal SR, Ghalaut VS. Evaluating the association between maternal vitamin D deficiency and preeclampsia among Indian gravidas.Eur J Obstet Gynecol Reprod Biol. 2021;261:103–9. [DOI] [PubMed]
Singh A, Mishra S, Aditya V, Srivastava R. Association of vitamin D deficiency with occurrence of pre eclampsia among inpatients of tertiary care centre, Gorakhpur, Uttar Pradesh, India.Int J Reprod Contracept Obstet Gynecol. 2016;5:1304–8. [DOI]
Negm SA, Abd-Elmoneim EF, El-Sayed HF. The relationship between vitamin D deficiency and preeclampsia.Int J Health Sci. 2022;6:5373–89. [DOI]
Mailer RKW, Joly AL, Liu S, Elias S, Tegner J, Andersson J. IL-1β promotes Th17 differentiation by inducing alternative splicing of FOXP3.Sci Rep. 2015;5:14674. [DOI] [PubMed] [PMC]
Chung Y, Chang SH, Martinez GJ, Yang XO, Nurieva R, Kang HS, et al. Critical regulation of early Th17 cell differentiation by interleukin-1 signaling.Immunity. 2009;30:576–87. [DOI] [PubMed] [PMC]