孕中期解脲支原体沙眼衣原体感染与小于胎龄儿的相关性分析

Correlation of ureaplasma urealyticum and chlamydia trachomatis infections in the second trimester of pregnancy with small for gestational age infants

目的探讨孕中期解脲支原体(UU)、沙眼衣原体(CT)感染与小于胎龄儿(SGA)的相关性,以期为早期预防不良妊娠结局提供参考依据。方法选取2018年5月-2020年5月北京市怀柔区妇幼保健院收治的112例分娩SGA的产妇作为观察组,选取同期分娩正常新生儿产妇112例作为对照组。实时荧光定量PCR(qPCR)法进行CT、UU检测;采用Logistic回归分析影响SGA发生的因素。结果观察组产妇UU感染率、CT感染率及UU+CT感染率(40.18%、24.11%、15.18%)均高于对照组(7.14%、4.46%、2.68%),差异有统计学意义(χ^(2)=33.836、17.646、9.278,P<0.05)。观察组产妇胎儿宫内窘迫、新生儿窒息、入住新生儿病房、早产、胎膜早破及早发型败血症比例均高于对照组,差异有统计学意义(χ^(2)=4.074、4.573、8.518、9.475、7.146、4.167,P<0.05)。多因素Logistic回归分析结果显示,UU感染、CT感染均是影响SGA发生的独立危险因素(OR=2.674、2.762,95%CI:1.149~6.223、1.139~6.698,P<0.05)。结论孕中期UU、CT感染与SGA有一定联系,对育龄及孕期妇女进行早期UU、CT筛查,具有重要的临床意义。

Objective To investigate the correlation of ureaplasma urealyticum(UU)and chlamydia trachomatis(CT)infections in the second trimester of pregnancy with small for gestational age(SGA)infants,in order to provide reference for early prevention of adverse pregnancy outcomes.Methods From May 2018 to May 2020,112 parturients with SGA infants born in the Beijing Huairou Maternal and Child Health Care Hospital were selected as the observation group,and 112 parturients with normal newborns born at the same period were selected into the control group.Real-time fluorescent quantitative PCR(qPCR)method was used for CT and UU detection.Logistic regression was used to analyze the factors affecting the occurrence of SGA.Results The maternal UU infection rate(40.18%),CT infection rate(24.11%)and UU+CT infection rate(15.18%)of the observation group were higher than those of the control group(7.14%,4.46%,2.68%)with significant differences(χ^(2)=33.836,17.646,9.278,P<0.05).The proportions of fetal distress,neonatal asphyxia,admission to neonatal ward,premature delivery,premature rupture of membranes and early-onset sepsis in the observation group were significantly higher than those in the control group(χ^(2)=4.074,4.573,8.518,9.475,7.146,4.167,P<0.05).Multivariate Logistic regression analysis showed that UU infection and CT infection were independent risk factors affecting the occurrence of SGA(OR=2.674,95%CI:1.149-6.223;OR=2.762,1.139-6.698,P<0.05).Conclusions UU and CT infections in the second trimester are related to SGA.Early screening of UU and CT for women of childbearing age and pregnant women has important clinical significance.