自然流产前患者阴道微生态评价与诱病危险因素分析

Vaginal microecology evaluation and analysis of predisposing risk factors of patients with spontaneous abortion

目的探究自然流产患者阴道分泌物微生态特征及其诱病危险因素。方法回顾性分析行早孕期阴道微生态检查的1147例孕妇临床资料,将孕28周前自然流产者纳入观察组(n=537),其余继续妊娠者纳入对照组(n=610)。对两组基线资料、阴道微生态指标进行单因素比较,就单因素差异存在统计学意义的项目进行非条件Logistic回归分析,筛选出影响自然流产的独立危险因素。结果非条件Logistic回归分析结果显示,有分娩史及阴道分泌物细菌性阴道病(BV)Nugent评分较高、念珠菌阳性、白细胞酯酶(LET)阳性均是影响自然流产发生的独立危险因素(P<0.05)。结论分娩史及阴道分泌物确诊BV、念珠菌感染、LET阳性均可独立诱发自然流产,可为产科临床防治工作提供参考与指导。

Objective To explore the microecological features of vaginal secretions and the predisposing risk factors in patients with spontaneous abortion.Methods The clinical data of 1147 pregnant women who underwent vaginal microecology in early pregnancy were retrospectively analyzed.The women with spontaneous abortions before 28 weeks of gestation were included in observation group(n=537),and the remaining women with continued gestation were included in control group(n=610).The baseline data and vaginal microecological indicators were analyzed by univariate comparisons,and unconditional Logistic regression analysis was performed to screen out independent risk factors affecting spontaneous abortion.Results Unconditional Logistic regression analysis showed that delivery history,high Nugent score of vaginal secretions bacterial vaginosis(BV),positive Candida and positive leukocyte esterase test(LET)were independent risk factors affecting the occurrence of spontaneous abortion(P<0.05).Conclusions The delivery history,and BV,Candida and LET detected in vaginal secretions can induce spontaneous abortion independently,and it is necessary to pay attention to the clinical prevention and treatment during pregnancy.