妊娠期女性生殖道感染的危险因素及对妊娠结局的影响

Risk Factors of Reproductive Tract Infection in Pregnant Women and its Effect on Pregnancy Outcome

目的分析妊娠期女性生殖道感染的危险因素及对妊娠结局的影响。方法选取我院2019年12月-2020年12月我院收治的418例妊娠期女性作为研究对象,根据分泌物培养及菌群鉴定结果将生殖道感染者作为研究组,其余妊娠期女性作为对照组。分析妊娠期女性生殖道感染情况以及病原菌分布,采用单因素及多因素分析生殖道感染的危险因素,并探讨生殖道感染对妊娠结局的影响。结果418例妊娠期女性中,共检测出176例生殖道感染,感染发生率为42.11%,其中混合感染93例,占比52.84%;单一感染83例,占比47.16%。病原体中解脲脲原体的占比最高,其次为凝固酶阴性葡萄球菌。研究组年龄、文化程度、分娩史、流产史、生殖系统感染史、糖尿病史、血红蛋白<100 g/L与对照组比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,文化程度、分娩史、流产史、糖尿病史是导致妊娠期女性生殖道感染的重要危险因素(P<0.05)。研究组早产、胎膜早破、低体重初生儿、死胎或围产儿死亡、胎儿窘迫、新生儿窒息发生率均高于对照组,差异有统计学意义(P<0.05)。结论妊娠期女性生殖道感染的病原菌中大多为革兰阳性菌和解脲脲原体,文化程度、分娩史、流产史以及糖尿病史是导致生殖道感染的高危因素,临床中应予以重视。

Objective To analyze the risk factors of reproductive tract infection in pregnant women and its effect on pregnancy outcome.Methods A total of 418 pregnant women admitted to our hospital from December 2019 to December 2020 were selected as the study subjects.According to the results of secretion culture and flora identification,genital tract infection was taken as the study group,and the remaining pregnant women were taken as the control group.The situation of reproductive tract infection in pregnant women and the distribution of pathogens were analyzed.The risk factors of reproductive tract infection were analyzed by single factor and multiple factors,and the influence of reproductive tract infection on pregnancy outcome was discussed.Results A total of 176 cases of reproductive tract infections were detected in 418 pregnant women,and the infection rate was 42.11%,of which 93 cases were mixed infections,accounting for 52.84%,83 cases were single infection,accounting for 47.16%.Ureaplasma urealyticum was the highest in pathogens,followed by coagulase-negative staphylococci.The age,education level,delivery history,abortion history,reproductive system infection history,diabetes history,hemoglobin<100 g/L in the study group were significantly different from those in the control group(P<0.05).Multivariate Logistic regression analysis showed that education level,delivery history,abortion history and diabetes history were important risk factors for reproductive tract infection in pregnant women(P<0.05).The incidences of premature delivery,premature rupture of membranes,low birth weight,stillbirth or perinatal death,fetal distress and neonatal asphyxia in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion Most pathogens causing reproductive tract infections in pregnant women are gram-positive bacteria and ureaplasma urealyticum.Education level,history of childbirth,history of abortion and history of diabetes are high risk factors for reproductive tract infections,which should be paid attention to in clinic.