妊娠晚期阴道微生态与早产的相关性研究

A correlation study of the vaginal microenvironment evaluation in the third trimester and premature labor

目的研究妊娠晚期阴道微生态与早产的相关性。方法选取2017年1月至2018年6月海淀区妇幼保健院进行产前检查的144例孕妇作为研究对象。孕周范围28周~34周+6天,诊断先兆早产或早产临产者104人,根据分娩孕周,有早产孕妇40人和足月孕妇64人。从足月孕妇64人中随机选取40人,作为足月组。早产孕妇40人作为早产组。无先兆早产症状的孕妇40人,有一人孕35+周早产胎膜早破后早产分娩,其余39人均足月分娩,此39人为对照组。所有入组孕妇均行阴道微生态检查,比较3组孕妇一般情况、母儿结局及微生态结果。结果①早产组阴道优势菌群为革兰阳性杆菌的比例,正常阴道菌群密集度的比例,正常阴道菌群多样性的比例明显低于足月组和对照组,差异有统计学意义(P<0.05)。②早产组细菌性阴道病、外阴阴道假丝酵母菌病、需氧菌阴道炎及微生态失调的发生率明显高于足月组和对照组,差异有统计学意义(P<0.05)。③三组的宫腔感染率、产褥感染率及新生儿感染率无统计学差异。结论妊娠晚期阴道微生态失调易导致早产。

Objective To research the correlation of the vaginal microenvironment evaluation in third trimester and premature labor. Methods 144 pregnant women in our hospital from January 2017 to June 2018 were chosen, with pregnant weeks of 28~34+6 weeks. 104 of them were diagnosed threatened premature labor or premature labor, who were divided into two groups according to the delivery weeks, 40 premature delivery women and 64 mature delivery women. 40 women from the 64 mature delivery women were randomly chosen as mature group, and 40 premature delivery women as premature group. 40 women didn′t have symptoms of threatened premature labor, of which 39 women were mature delivery as control group. All the pregnant women underwent vaginal microecological examination. The general condition, outcomes of gestation and results of microenvironment evaluation were compared among the 3 groups. Results 1. The proportion of vaginal predominant bacteria being gram positive bacilli, the proportion of normal vaginal bacteria density, the proportion of normal vaginal flora diversity in preterm labor group was significantly lower than that in the mature group and control group, with statistically significant differences(P<0.05). 2. The incidence of bacterial vaginosis, vulvovaginal candidiasis, aerobic vaginitis and microecological disorders in the premature group was significantly higher than that in the mature group and control group, with statistically significant differences(P<0.05). 3. There was no significant difference in the rates of intrauterine infection, puerperal infection and neonatal infection among the 3 groups. Conclusions The disorders of vaginal microenvironment evaluation in the third trimester may lead to premature labor.