人支原体和巨细胞病毒感染对妊娠结局的影响

Effects of human mycoplasma and cytomegalovirus infection on pregnancy outcome

目的检测性传播支原体、脲原体、单纯疱疹病毒(HSV)和巨细胞病毒(CMV)的诊断测试在临床环境中不作为常规检查,且这些STI(性传播感染)的频率是未知的,探讨人支原体和巨细胞病毒感染对妊娠结局的影响。方法在与妊娠结局相关的200名孕妇及其新生儿中对这些性病病原体的患病率进行前瞻性评估,聚合酶链反应用于检测孕妇的阴道拭子和新生儿的口腔拭子中的细菌和病毒性STI病原体,制定关于前妊娠和当前妊娠的标准化问卷,应用线性回归分析来将病原体检测与妊娠结果相关联。结果脲原体是测试的病原体中最常见的(90.5%阳性女性和47.5%阳性新生儿),其次是支原体(32.5%和7.5%),衣原体(14.5%和7.5%),毛滴虫(8.5%和4.0%和淋球菌(0.5%和0)。在46.5%的孕妇和10.5%的新生儿中发现CMV,仅在2个母亲中发现HSV-2。结论具有解脲脲原体、人支原体、阴道毛滴虫或CMV的母体的定植与对新生儿的垂直传播相关,并且从妊娠妇女到后代的人支原体或CMV的传播与新生儿身长和孕龄的减少有关,应在临床环境中实施其检测的诊断测试。

Objective To investigate the effects of human mycoplasma and cytomegalovirus infection on pregnancy outcome.Methods The prevalences of human mycoplasma and cytomegalovirus infection in 200 pregnant women and their neonates were prospectively evaluated.The polymerase chain reaction was used to detect the bacterial and viral STI pathogens in vaginal swabs of pregnant women and oral swabs of newborns.A standardized questionnaire about prepregnancy and current pregnancy was instituted,moreover,the linear regression analysis was used to analyze the correlation between pathogen detection and pregnancy outcome.Results The ureaplasma was the most common pathogen in the detection with positive rate being 90.5%in preganant women and 47.5%in neonates,followed by mycoplasma(32.5%and 7.5%,respectively),chlamydia(14.5%and 7.5%),trichomonas(8.5%and 4.0%)and neisseria gonorrhoeae(0.5%and 0).CMV was found in 46.5%of pregnant women and 10.5%of newborns,HSV-2 was found only in two mothers.Conclusion The multiple regression analysis showes that the maternal colonization of ureaplasma urealyticum,human mycoplasma,trichomonas vaginalis or CMV is associated with the vertical transmission of neonates,moreover,the transmission of human mycoplasma or CMV from pregnant women to future generations is associated with the decrease of neonatal body length and gestational age.Therefore,the diagnostic detection should be performed in clinical practice.