衣原体属感染不同孕期治疗的妊娠结局分析

Outcome of treatment during different pregnancies in chlamydial infection

目的观察衣原体属感染不同孕期治疗对产妇妊娠结局及新生儿的影响,探讨早期治疗的重要性,为产前筛查提供理论依据。方法将2011年5月-2015年5月于医院生产的80例衣原体属感染的孕妇,按孕期发现和治疗时间分组,其中早孕组（孕期〈13＋6周）22例,中孕组32例（孕期14~27＋6周）,晚孕组26例（孕期≥28周）,3组孕妇均口服阿奇霉素治疗,观察妊娠合并衣原体属感染不同孕期治疗的效果,即产妇妊娠结局及新生儿结局的变化。结果不同孕期产妇治疗后妊娠结局比较,早孕组胎膜早破、羊水过少、胎儿生长受限、前置胎盘、产褥感染的发生率分别为4.55%、0、0、0、0;中孕组分别为28.13%、18.75%、25.00%、3.13%、15.63%;晚孕组分别为38.46%、26.92%、30.77%、19.23%、26.92%,组间比较差异均有统计学意义（χ^2=7.589、6.592、7.885、7.824、6.791,P〈0.05）;产妇新生儿结局比较,早孕组早产、低出生体重儿、新生儿黄疸、新生儿肺炎、新生儿结膜炎的发生率分别为0、13.64%、18.18%、9.09%、9.09%;中孕组分别为25.00%、34.38%、40.63%、28.13%、31.25%;晚孕组分别为42.31%、57.69%、65.38%、46.15%、50.00%,组间比较差异有统计学意义（χ^2=11.825、10.090、10.942、8.001、9.283,均P〈0.05）。结论对妊娠合并衣原体属感染早期治疗可明显改善产妇妊娠结局和产后新生儿结局,医务工作者应重视产前筛查,早期发现并积极治疗妊娠合并衣原体属感染,改善产妇妊娠结局。

OBJECTIVE To observe the maternal outcome and the effect on neonates of the treatment during pregnancies in chlamydial infection,on the importance of early treatment,to provide a theoretical basis for prenatal screening.METHODS A total of 80 cases pregnant women with chlamydial infection in hospitals from May,2011 to May,2015 were divided into three groups according to the time of detection and treatment,including early pregnancy（gestation 13＋6 weeks）with 22 cases,middle pregnancy（14-27＋6 weeks of pregnancy）with 32 cases,and late pregnancy（≥28weeks of pregnancy）with 26 cases.Three groups of patients were given azithromycin taken orally.The maternal outcome and the effect on infants of the treatment during pregnancies in chlamydial infection were observed.RESULTS The outcomes in different pregnancies were as followed：the rates of premature rupture of membranes,oligohydramnios,fetal growth restriction,placenta previa and puerperal infection in early pregnancy group were respectively 4.55%,0,0,0and 0;in middle pregnancy group were respectively 28.13%,18.75%,25.00%,3.13% and 15.63%;and in late pregnancy group were respectively 38.46%,26.92%,30.77%,19.23% and 26.92%.It was significant（χ^2= 7.589,6.592,7.885,7.824,6.791,P〈0.05）between groups.For the outcomes of neonates,the rates of early preterm birth,low birth weight children,neonatal jaundice,neonatal pneumonia,neonatal conjunctivitis occurrence in early pregnancy group were respectively 0%,13.64%,18.18%,9.09% and 9.09%;in middle pregnancy group were respectively 25.00%,34.38%,40.63%,28.13% and 31.25%;and in late pregnancy group were respectively 42.31%,57.69%,65.38%,46.15% and 50.00%.It was significant（χ^2=11.825,10.090,10.942,8.001,9.283,P〈0.05）between groups.CONCLUSIONEarly treatment of pregnant women with chlamydial infection can significantly improve pregnancy outcomes and neonatal outcomes.Medical workers should pay attention to prenatal screening,early detection and aggressive treatment of pregnant women with chlamydial infection in order to improve the pregnancy outcomes.