妊娠期阴道病患者微生态特征及危险因素分析

Microecological characteristics and risk factors analysis of vaginosis during pregnancy

目的探讨妊娠期阴道病患者微生态特征及其发生阴道病的危险因素,为疾病的预防和治疗提供理论依据。方法对2019年6月—2021年6月在本院就诊的812例妊娠期阴道病妇女取阴道分泌物,以及同期孕检健康的孕妇1047例,观察阴道清洁度、病原菌感染情况等微生态指标,统计病原微生物分布情况,进行Logistic回归分析,探讨发生妊娠期阴道病的相关危险因素。结果812例妊娠期阴道病患者阴道清洁度Ⅲ度626例,占77.09%;Ⅳ度91例,占11.21%。真菌感染242例,细菌性阴道病209例,支原体感染198例。多因素Logistic回归分析显示,叶酸、维生素D低、便秘、孕前吸烟、喝酒史、既往阴道病病史、既往多次流产史、孕期未使用避孕套、内裤材质非纯棉、孕期糖尿病是妊娠期阴道病发生的独立危险因素(P<0.05),接触过孕期健康教育是保护因素(P<0.05)。结论针对高危因素,应提高防治认知以降低妊娠期阴道病发生率。

Objective To investigate the microecological characteristics and risk factors of vaginosis in pregnancy patients,and to provide theoretical basis for the prevention and treatment of the disease.Methods Vaginal secretions were collected from a total of 812 cases of women with vaginal disease during pregnancy in our hospital from June 2019 to June 2021,and microecological indicators such as vaginal cleanliness and pathogen infection were observed,and the distribution of pathogenic microorganisms was counted.Meanwhile,1047 healthy pregnant women during pregnancy examination were selected as the control group.The clinical data of patients in the case group and the control group were compared and Logistic regression analysis was conducted to explore the risk factors of vaginal disease during pregnancy.Results Vaginal cleanlinessⅢdegree was found in626 cases(77.09%)of 812 patients with vaginal disease during pregnancy.Ⅳdegree was observed in 91 cases(11.21%).Among them,there were 242 cases of fungal infection,209 cases of bacterial vaginosis,198 cases of mycoplasma infection.Multivariate Logistic regression analysis showed that low folic acid and vitamin D,constipation,smoking and drinking history before pregnancy,previous history of vaginal disease,history of multiple abortions,no use of condoms during pregnancy,non-cotton underwear material,gestational diabetes were independent risk factors for vaginal disease in pregnant women(P<0.05).Exposure to prenatal health education is a protective factor(P<0.05).Conclusion In view of the high risk factors,the prevention and treatment awareness should be improved to reduce the incidence of vaginosis during pregnancy.