妊娠合并外阴阴道假丝酵母菌病的调查研究

Research on Vulvovaginal Candidiasis in Pregnant Women

目的对妊娠合并外阴阴道假丝酵母菌病(vulvovaginal candidiasis,VVC)的危险因素及妊娠结局进行流行病学调查,为妊娠合并VVC的预防提供理论依据。方法对310例有阴道炎症状的妊娠妇女阴道分泌物分别做BV、VVC、滴虫、衣原体及淋球菌5项检测,并由专人对妊娠合并VVC患者进行发病情况及妊娠结局的调查和随诊。结果 310例有阴道炎症状的妊娠妇女中VVC所占比例为44.8%,且中孕期与晚孕期之间VVC发病率无明显差异(P>0.05);妊娠合并VVC的危险因素包括孕前VVC史、孕期常用护垫、穿紧身裤袜、性生活不清洁、配偶生殖器感染、不勤换内裤,锻炼身体和避孕套的使用则属于保护性因素;妊娠合并VVC患者早产、足月低体重儿、胎膜早破、产褥感染和绒毛膜羊膜炎的发生率分别为11.2%、8.8%、33.6%、6.4%和8.0%,显著高于正常对照组2.7%、1.8%、15.5%、0.9%和1.8%的发生率,组间差异具有统计学意义(P<0.05)。结论外阴阴道假丝酵母菌病为妊娠期妇女较常见的阴道感染性疾病,其发病受多种因素影响,并且妊娠合并VVC可增加孕妇造成不良妊娠结局的机会。

Objective To investigate the predisposing factors of pregnancy complicated with vulvovagi- hal candidiasis（VVC） and pregnancy outcome. Methods Vaginal secretion from 310 pregnancy women with the symptom of vaginosis was detected for BV, VVC, trichomonad, chlamydia and gonorrhoeae. Then the predispo- sing factors of pregnancy complicated vulvovaginal candidiasis were investigated, and the pregnancy outcome was followed up. Results The prevalence of VVC in pregnant women was 44.8% ,and there is no difference be- tween the second and the third trimester（ P 〉 0.05 ）. The predisposing factors for pregnancy complicated vulvo- vaginal candidiasis included progestational VVC, feminine hygiene products, wearing tight clothing, poor sex hy- giene, genital infection of the sexual porter, etc ; while physical exercise and condom use were the protective fac- tors. The incidences of preterm delivery, low-birth-weight babies, premature rupture of membranes, puerperal in- fection and chorioamnionitis were 11.2% ,8.8% ,33.6% ,6.4% and 8.0% in pregnancy and vulvovaginal candidiasis respectively, which were significantly higher than those without VVC （ 2.7 %, 1.8 %, 15.5 %, 0.9 % and 1.8% ）（P 〈 0.05 ）. Conclusion Vulvovaginal candidiasis is quite common vaginosis in pregnant women and can be influenced by multiple factors. VVC can increase the chance of adverse pregnancy outcome.