Blake R L, Gay J W, Brown S, Smith W
Department of Family and Community Medicine, University of Missouri-Columbia 65212.
J Am Board Fam Pract. 1992 Nov-Dec;5(6):555-63.
Preterm delivery is the most common cause of neonatal morbidity and mortality in the United States. There is evidence that cervicovaginal infection could predispose to preterm labor. This study explored a possible association of evidence of inflammation on an otherwise normal Papanicolaou smear obtained during pregnancy with subsequent preterm labor and preterm delivery.
Using a retrospective matched cohort design, we studied women who gave birth to live singleton infants at the University of Missouri Hospital and Clinics during a 21-month period. Papanicolaou smears were obtained from 1 to 8 months before delivery and were interpreted in the same cytopathology laboratory. Data pertaining to outcome variables and potential confounding variables were collected from hospital charts.
Incidence rates were 14.4 percent for labor < 37 weeks' gestation (preterm labor), 12.3 percent for hospitalization for preterm labor, 9.9 percent for delivery < 37 weeks (preterm delivery), 2.6 percent for delivery < 34 weeks, and 7.5 percent for birth weight < 2500 g. On univariate and multivariate analyses, there were no significant differences in any outcome between the 293 women with inflammation and the 284 women without inflammation on Papanicolaou smear. Results were unchanged when the analysis was limited to the 412 women who received no antibiotics during pregnancy. Among the 38 women with a history of preterm labor or preterm delivery, those with cervical inflammation had a higher rate of preterm labor than those without inflammation.
In the sample as a whole, there was little evidence that findings of inflammation on Papanicolaou smear constituted a risk factor for preterm labor or preterm delivery. The data suggest that inflammation could be associated with an increased risk in a subgroup of women at higher risk by virtue of their obstetric history.
在美国，早产是新生儿发病和死亡的最常见原因。有证据表明宫颈阴道感染可能易引发早产。本研究探讨了孕期获得的巴氏涂片结果正常但存在炎症迹象与随后早产及分娩之间的可能关联。
采用回顾性匹配队列设计，我们研究了在21个月期间于密苏里大学医院及诊所分娩单胎活婴的女性。在分娩前1至8个月获取巴氏涂片，并在同一细胞病理学实验室进行解读。从医院病历中收集与结局变量和潜在混杂变量相关的数据。
妊娠<37周分娩（早产）的发生率为14.4%，因早产住院的发生率为12.3%，<37周分娩（早产）的发生率为9.9%，<34周分娩的发生率为2.6%，出生体重<2500g的发生率为7.5%。在单因素和多因素分析中，巴氏涂片有炎症的293名女性与无炎症的284名女性在任何结局方面均无显著差异。当分析仅限于孕期未使用抗生素的412名女性时，结果未变。在有早产或早产史的38名女性中，有宫颈炎症的女性早产发生率高于无炎症者。
在整个样本中，几乎没有证据表明巴氏涂片上的炎症表现构成早产或早产的危险因素。数据表明，炎症可能与因产科病史而处于较高风险的女性亚组中增加的风险相关。
