Tran Susan H, Caughey Aaron B, Musci Thomas J
Department of Obstetrics and Gynecology, Kaiser Permanente, San Francisco, CA, USA.
Am J Obstet Gynecol. 2003 Sep;189(3):746-50. doi: 10.1067/s0002-9378(03)00767-1.
The purpose of this study was to determine whether meconium-stained amniotic fluid is associated with puerperal infection and whether the quality of the meconium is further associated with this risk.
We designed a retrospective cohort study of all deliveries beyond 37 weeks gestational age from 1992 to 2002 at a single community hospital. Data were collected on rates of chorioamnionitis, endomyometritis, quality of amniotic fluid, and length of labor and analyzed with bivariate and multivariate analyses.
We found that, among the 43,200 women who were delivered at term, 18.9% of the women had meconium staining (8.8% thin, 5.5% moderate, 4.6% thick). Compared with deliveries with clear amniotic fluid, those with meconium-stained amniotic fluid had higher rates of chorioamnionitis (2.3% vs 4.1%, P<.001) and endomyometritis (1.0% vs 1.7%, P<.001). Further, the severity of meconium staining was associated with increased rates of infection.
We found that the presence and severity of meconium-stained amniotic fluid is associated with puerperal infection even when being controlled for confounders.
本研究旨在确定羊水胎粪污染是否与产褥感染相关,以及胎粪质量是否与该风险进一步相关。
我们设计了一项回顾性队列研究,纳入了1992年至2002年在一家社区医院足月分娩的所有孕妇。收集了绒毛膜羊膜炎、子宫内膜炎的发生率、羊水质量和产程长度的数据,并进行了双变量和多变量分析。
我们发现,在43200名足月分娩的女性中,18.9%的女性有胎粪污染(8.8%为稀薄,5.5%为中度,4.6%为浓稠)。与羊水清澈的分娩相比,羊水胎粪污染的分娩有更高的绒毛膜羊膜炎发生率(2.3%对4.1%,P<0.001)和子宫内膜炎发生率(1.0%对1.7%,P<0.001)。此外,胎粪污染的严重程度与感染率增加相关。
我们发现,即使在控制混杂因素后,羊水胎粪污染的存在和严重程度仍与产褥感染相关。