孕妇生殖道支原体寄居与异常围生结局关系的前瞻性研究

A prospective study on relationship between genital tract mycoplasma infection in pregnant women and adverse perinatal outcomes

目的 探索孕妇生殖道支原体寄居与异常围生结局的病因学关系。方法 选择进行围生期保健孕妇739例,根据支原体检测结果将其分成支原体阳性孕妇队列和支原体阴性孕妇队列,随访至围生期结束,比较2组异常围生结局发生率。结果 支原体阳性孕妇队列中早产、产后热、产褥感染及胎儿宫内窘迫的发生率高于支原体阴性孕妇队列(P<0.05)。分析不同支原体寄居与异常围生结局关系,发现解脲脲原体主要引起早产(RR=3.28,95％CI为1.75～6.14)和胎儿宫内窘迫(RR=3.61,95％CI为1.56～8.33)发生率增加;人型支原体主要导致新生儿肺炎(RR=5.16,95％CI为1.99～13.38)、产后热(RR=5.91,95％CI为2.01～17.42)和产褥感染(RR=4.14,95％CI为1.79～9.6)等异常围生结局发生率的增加。支原体混合寄居表现出协同效应。结论 围生期孕妇生殖道支原体寄居能引起异常围生结局发生率的增加,应大力加强对孕妇支原体寄居的防治工作。

Objective To explore etiologic relationship between genital tract mycoplasma infection and adverse perinatal outcomes. Methods 739 pregnant women who were undertaking perinaptal care in Tong Ji Hospital and International Peace Care Hospital were divided into mycoplasma - positive group and mycoplasma - negative group according to mycoplasma culture results, and followed up to the end of perinatal period. Comparison of adverse perinatal outcome incidence was made between the two groups. Results The incidences of preturm labor , post partum fever, puerperal infection and fetal inrauterus distress in mycoplasma -positive group were higher than those in mycolasma-negative group (P < 0.05). It was found that ureaplasma urealyticum played adverse role in preterm labor (RR = 3. 28, 95 % CI and 1. 75-6. 14), and fetal intrauterus distress (RR = 3. 61, 95 % CI 1. 56-8. 33), and mycoplasma hominis mainly led to increase of incidence rate of neonate pneumonia (RR = 5. 16, 95 % CI 1. 99-13- 38), post parum fever (RR = 5. 91, 95 % CI 2. 01 - 17. 42) and puerperal infection (RR = 4. 14, 95 % CI 1. 79 -9. 6). Mixture Mycoplasma infection existed co - effect and led to severely adverse perinatal outcome. Conclusion Genital tract mycoplasma infection in preinatal women can give rise to increase of adverse perinatal outcomes incidence. Thus, the prevention and cure shuold be greatly strengthened on genital tract mycoplasma infection in perinatal women.