Andrews W W, Goldenberg R L, Mercer B, Iams J, Meis P, Moawad A, Das A, Vandorsten J P, Caritis S N, Thurnau G, Miodovnik M, Roberts J, McNellis D
National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network, the University of Alabama at Birmingham, Birmingham, AL 35249-7333, USA.
Am J Obstet Gynecol. 2000 Sep;183(3):662-8. doi: 10.1067/mob.2000.106556.
This study was undertaken to determine the association between genitourinary tract infection with Chlamydia trachomatis and spontaneous preterm birth.
Genitourinary tract infection with C trachomatis was determined with a ligase chain reaction assay of voided urine samples collected at 24 weeks' gestation (22 weeks' to 24 weeks 6 days' gestation) and 28 weeks' gestation (27 weeks' to 28 weeks 6 days' gestation). Case patients (spontaneous preterm birth at <37 weeks' gestation; n = 190) and control subjects (delivery at >/=37 weeks' gestation, matched for race, parity, and center; n = 190) were selected from 2929 women enrolled in the Preterm Prediction Study of the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network.
Genitourinary C trachomatis infection (11% overall) was significantly more common among the case patients than among the control subjects at 24 weeks' gestation (15.8% vs 6.3%; P =.003) but not at 28 weeks' gestation (12.6% vs 10.9%; P =.61). Women with chlamydia infection were more likely to have bacterial vaginosis (57.1% vs 32.9%; P =.002) and a short cervical length (</=25 mm; 33.0% vs 17.9%; P =.02) but not a body mass index <19.8 kg/m(2) (35.0% vs 23.9%; P =.17) or a positive fetal fibronectin test result (7.1% vs 9.5%; P =.62). After adjustment for risk factors for spontaneous preterm birth, women with C trachomatis infection at 24 weeks' gestation were 2 times as likely as uninfected women to have a spontaneous preterm birth at <37 weeks' gestation (odds ratio, 2.2; 95% confidence interval, 1.03-4.78) and 3 times as likely to have a spontaneous preterm birth at <35 weeks' gestation (odds ratio, 3.2; 95% confidence interval, 1.08-9.57).
Genitourinary C trachomatis infection at 24 weeks' gestation was associated with a 2-fold to 3-fold increased risk of subsequent spontaneous preterm birth.
本研究旨在确定沙眼衣原体引起的泌尿生殖道感染与自发性早产之间的关联。
采用连接酶链反应分析法，对在妊娠24周（妊娠22周0天至24周6天）和妊娠28周（妊娠27周0天至28周6天）收集的晨尿样本进行沙眼衣原体泌尿生殖道感染检测。病例组患者（妊娠<37周时自发性早产；n = 190）和对照组受试者（妊娠≥37周分娩，根据种族、产次和中心进行匹配；n = 190）选自参与美国国立儿童健康与人类发展研究所母胎医学单位网络早产预测研究的2929名女性。
泌尿生殖道沙眼衣原体感染（总体为11%）在病例组患者中比对照组受试者在妊娠24周时更为常见（15.8%对6.3%；P = 0.003），但在妊娠28周时并非如此（12.6%对10.9%；P = 0.61）。衣原体感染的女性更易患细菌性阴道病（57.1%对32.9%；P = 0.002）且宫颈长度较短（≤25 mm；33.0%对17.9%；P = 0.02），但体重指数<19.8 kg/m²的情况并非更常见（35.0%对23.9%；P = 0.17），胎儿纤连蛋白检测结果为阳性的情况也并非更常见（7.1%对9.5%；P = 0.62）。在对自发性早产的危险因素进行校正后，妊娠24周时感染沙眼衣原体的女性发生妊娠<37周时自发性早产的可能性是未感染女性的2倍（比值比，2.2；95%置信区间，1.03 - 4.78），发生妊娠<35周时自发性早产的可能性是未感染女性的3倍（比值比，3.2；95%置信区间，1.08 - 9.57）。
妊娠24周时泌尿生殖道沙眼衣原体感染与随后发生自发性早产的风险增加2至3倍相关。
