妊娠期生殖道感染对妊娠结局的影响

Influence of gestational reproductive tract infection on pregnancy outcome

目的分析妊娠期生殖道感染对于妊娠结局的影响。方法对2020年10月—2022年10月在永康市妇幼保健院进行定期产检和住院分娩的孕妇进行临床资料分析。在分析过程中,将存在生殖道感染的孕妇作为感染组,无生殖道感染的孕妇作为对照组进行对比研究,进而得出感染组和对照组妊娠结局的差异。结果367例妊娠期女性中,阴道分泌物检测阳性的女性有143例,患病率为38.96%,将其作为感染组,阴道分泌物检测阴性的女性有224例,占61.04%,将其作为对照组。感染组患者平均年龄为(28.35±3.32)岁,初次发现生殖道感染的孕周为(36.52±0.5)周。对照组平均年龄为(28.77±2.87)岁,初次检测阴道分泌物的孕周为(36.58±0.6)周。感染组患者感染病原类型包含支原体感染50例,占34.97%;念珠球菌感染37例,占25.87%;B族链球菌感染23例,占16.08%;淋球菌感染12例,占8.39%;其他感染21例,占14.69%。感染组的不良妊娠结局包括早产11例,占7.69%;胎膜早破9例,占6.29%;低体质量儿5例,占3.50%,胎儿窘迫4例,占2.80%;新生儿窒息4例,占2.80%;对照组的不良妊娠结局包括早产6例,占2.68%;胎膜早破4例,占1.79%;低体质量儿2例,占0.90%,胎儿窘迫1例,占0.45%;新生儿窒息2例,占0.90%。感染组各不良妊娠结局发生率均明显高于对照组,差异均有统计学意义(χ^(2)=6.132、4.335、3.965、3.564及4.324,均P<0.05)。感染组孕妇剖宫产分娩47例,剖宫产率为32.87%,对照组孕妇剖宫产分娩40例,剖宫产率为17.86%,两组间剖宫产率比较,差异有统计学意义(χ^(2)=4.765,P<0.05)。结论妊娠期生殖道感染对母婴结局的影响较为显著。如果未及时治疗,可能会导致不良母婴结局发生率增加。因此,在妊娠期间,应该积极避免生殖道感染的发生,并及时对已经感染的病情进行治疗,以改善妊娠结局。

Objective To analyze the influence of reproductive tract infection on pregnancy outcome during pregnancy.Methods From October 2020 to October 2022,the clinical data of pregnant women who had regular antenatal check-up and hospitalized delivery in Yongkang Maternal and Child Health Hospital were analyzed.In the process of analysis,pregnant women with reproductive tract infection were taken as the infection group and pregnant women without reproductive tract infection were taken as the control group for comparative study,and then the difference of pregnancy outcome between the infection group and the control group was obtained.Results Among 367 pregnant women,143 cases tested positive for vaginal secretions were taken as infection group,and 224 cases tested negative for vaginal se-cretions,accounting for 61.04%,were taken as control group.The mean age of patients in the infected group was(28.35±3.32)years,and the gestational age of first discovery of reproductive tract infection was(36.52±0.5)weeks.The mean age of the control group was(28.77±2.87)years,and the gestational age of first detection of vaginal secretions was(36.58±0.6)weeks.In the infection group,50 cases(34.97%)were mycoplasma infection.Candida infection in 37 cases(25.87%);Group B streptococcus infection in 23 cases,ac-counting for 16.08%;Gonococcal infection in 12 cases(8.39%);Other infections were 21 cases,accounting for 14.69%.The adverse pregnancy outcomes in the infection group included 11 preterm births(7.69%).Premature rupture of fetal membrane occurred in 9 cases(6.29%).There were 5 cases of low body weight infants(3.50%)and 4 cases of fetal distress(2.80%).There were 4 cases of neonatal asphyxia,accounting for 2.80%;The adverse pregnancy outcomes in the control group included 6 preterm births,accounting for 2.68%;Premature rupture of fetal membrane occurred in 4 cases(1.79%).There were 2 cases of low body weight infants(0.90%)and 1 case of fetal distress(0.45%).Neonatal asphyxia was found in 2 cases,accounting for 0.90%.The incidence of adverse pregnancy outcomes in the infected group was significantly higher than that in the control group,with statistical significance(χ^(2)=6.132,4.335,3.965,3.564 and 4.324,all P<0.05).There were 47 cases of cesarean section in the infected group,the cesarean section rate was 32.87%,and 40 cases in the control group,the cesarean section rate was 17.86%,the difference between the two groups was statistically significant(χ^(2)=4.765,P<0.05).Conclusion Gestational reproductive tract infection has a significant effect on maternal and infant outcomes.If left un-treated,it may lead to an increased incidence of adverse maternal and infant outcomes.Therefore,during pregnancy,It should actively a-void the occurrence of reproductive tract infection,and timely treatment of already infected conditions to improve pregnancy outcomes.