Khan M Y, Mah M W, Memish Z A
Department of Medicine, King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia.
Clin Infect Dis. 2001 Apr 15;32(8):1172-7. doi: 10.1086/319758. Epub 2001 Apr 2.
Brucella species occasionally cause spontaneous human abortion, but theories regarding whether they do so more frequently than do other infectious pathogens remain controversial. We reviewed 92 pregnant women who presented with acute brucellosis at a Saudi Arabian hospital. From 1983 through 1995, the cumulative incidence of pregnancy and brucellosis was 1.3 cases per 1000 delivered obstetrical discharges. The incidence of spontaneous abortion in the first and second trimesters was 43%, and the incidence of intrauterine fetal death in the third trimester was 2%. Antepartum antimicrobial therapy with cotrimoxazole or cotrimoxazole/rifampin was protective against spontaneous abortion (relative risk, 0.14; 95% confidence interval, 0.06--0.37; P<.0001). The beneficial effect of treatment occurred in women with febrile illness; vaginal bleeding at presentation usually led to spontaneous abortion. This study demonstrated that the incidence of spontaneous abortion among pregnant women with brucellosis is high and that these women should receive prompt therapy with antimicrobial agents when they present for medical care.
布鲁氏菌属偶尔会导致人类自然流产，但关于它们导致自然流产的频率是否高于其他传染性病原体的理论仍存在争议。我们回顾了沙特阿拉伯一家医院92例患有急性布鲁氏菌病的孕妇。1983年至1995年期间，妊娠合并布鲁氏菌病的累积发病率为每1000例产科出院病例中有1.3例。孕早期和孕中期自然流产的发生率为43%，孕晚期宫内胎儿死亡的发生率为2%。产前使用复方新诺明或复方新诺明/利福平进行抗菌治疗可预防自然流产（相对危险度，0.14；95%可信区间，0.06 - 0.37；P<0.0001）。治疗的有益效果出现在发热疾病的女性中；就诊时出现阴道出血通常会导致自然流产。这项研究表明，患布鲁氏菌病的孕妇自然流产的发生率很高，这些女性就医时应立即接受抗菌药物治疗。
