孕期B族链球菌与支原体和衣原体感染对胎膜早破和妊娠结局的影响

Influence of gestational group B Streptococcus,Mycoplasma and Chlamydiainfections on premature rupture of membranes and pregnancy outcomes

目的探讨孕期B族链球菌、支原体、衣原体感染与胎膜早破的关系及对妊娠结局的影响。方法选择2011年1月-2015年12月医院产科符合纳入标准的胎膜早破孕妇200例为胎膜早破组,同期胎膜未破正常孕妇200例为对照组,胎膜早破孕妇被分为足月胎膜早破患者88例和未足月胎膜早破患者112例。分析比较宫颈分泌物B族链球菌、支原体、衣原体感染情况。结果胎膜早破组支原体和衣原体感染率分别为44.00%、6.50%,高于对照组的24.00%、1.50%(P<0.05);足月胎膜早破患者支原体感染率低于未足月胎膜早破患者(P<0.05);B族链球菌感染患者及衣原体感染患者的绒毛膜羊膜炎、早产、产后出血、新生儿窒息、低体重儿的发生率分别高于B族链球菌未感染患者与衣原体未感染患者(P<0.05),新生儿体质量低于B族链球菌未感染患者(P<0.05);支原体感染患者早产、新生儿窒息、低体重儿的发生率高于支原体未感染患者(P<0.05),新生儿体质量低于支原体未感染患者(P<0.05)。结论胎膜早破孕妇支原体和衣原体感染率升高,B族链球菌、支原体、衣原体感染均增加不良妊娠结局的发生风险。

OBJECTIVE To explore the relationship between the gestational group B Streptococcus（GBS）,Mycoplasma and Chlamydiainfections and the premature rupture of membranes（PROM）and observe the influence on pregnancy outcomes.METHODS From Jan 2011 to Dec 2015,a total of 200 pregnant women with PROM who were eligible for inclusion criteria of obstetrics department were chosen as the PROM group,meanwhile,200 pregnant women with normal fetal membranes were set as the control group.The pregnant women with PROM were divided into the full-term PROM group with 88 cases and the preterm PROM group with 112 cases.The prevalence of cervical secretions GBS,Mycoplasma and Chlamydia infections was observed and compared.RESULTS The incidence rate of Mycoplasmainfection was 44.00%in the PROM group,higher than 24.00%in the control group;the incidence rate of Chlamydiainfection was 6.50%in the PROM group,higher than 1.50%in the control group（P〈0.05）.The incidence rate of Mycoplasma infection of the full-term PROM group was lower than that of the preterm PROM group（P〈0.05）.The incidence rates of chorioamnionitis,premature birth,postpartum hemorrhage,neonatal asphyxia and low birth weight were respectively higher in the patients with GBS infection or Chlamydiainfection than in the patients without GBS or Chlamydiainfection（P〈0.05）.The neonatal body weight of the patients with GBS infection was less than that of the patients without GBS infection（P〈0.05）.The incidence rates of premature birth,neonatal asphyxia and low birth weight were higher in the patients with Mycoplasmainfection than in the patients without Mycoplasmainfection（P〈0.05）,and the neonatal body weight of the patients with Mycoplasmainfection was less than that of the patients without Mycoplasmainfection（P〈0.05）.CONCLUSIONThe prevalence rates of Mycoplasma infection and Chlamydiainfection are increased in the pregnant women with PROM.The GBS,Mycoplasma and Chlamydia infections may increase the risk of adverse pregnancy outcomes.