Shimano Satoshi, Nishikawa Akira, Sonoda Tomoko, Kudo Ryuichi
Department of Obstetrics and Gynecology, Tonan Hospital, Sapporo, Hokkaido, Japan.
J Obstet Gynaecol Res. 2004 Jun;30(3):230-6. doi: 10.1111/j.1447-0756.2004.00181.x.
Our aims were to evaluate the prevalence of bacterial vaginosis (BV), Chlamydia trachomatis (C. trachomatis) infection and Mobiluncus spp. infection among pregnant women in Otaru, Hokkaido, Japan according to the month and year of the first prenatal visit, and to evaluate their risk factors.
Six thousand and eighty-three pregnant women who were seen consecutively at our hospital between 1993 and 2000, were enrolled in the study. Vaginal and endocervical swabs were subjected to Gram stain and detection of C. trachomatis. Univariate and multivariate methods were used to investigate the association between each infection and potential risk factors including age, gravidity, parity, history of dilatation and curettage (D & C), and history of natural abortion.
The annual rate of BV increased from 13.6% in 1993 to 21.4% in 2000. The annual rate of C. trachomatis infection was relatively constant. The prevalence of bacterial vaginosis, C. trachomatis infection and Mobiluncus spp. infection over the 8-year period was 18.2%, 4.2%, and 4.1%, respectively. The prevalence of the three infections was significantly higher among teenagers and among women with a history of D & C. The prevalence of C. trachomatis and Mobiluncus spp. infections was significantly higher among women with no history of delivery. BV was not associated with parity on multivariate analysis. The monthly prevalence of BV was significantly higher in May than in December, and the monthly prevalence of C. trachomatis infection was high in August.
The differences in the annual and monthly infection patterns between BV and C. trachomatis infection suggest that the etiologies of the two infections differ.
我们的目的是根据首次产前检查的月份和年份,评估日本北海道小樽市孕妇中细菌性阴道病(BV)、沙眼衣原体(C. trachomatis)感染和动弯杆菌属感染的患病率,并评估其危险因素。
1993年至2000年期间在我院连续就诊的6083名孕妇纳入本研究。对阴道和宫颈拭子进行革兰氏染色及沙眼衣原体检测。采用单因素和多因素方法研究每种感染与潜在危险因素之间的关联,这些危险因素包括年龄、孕次、产次、刮宫术(D&C)史和自然流产史。
BV的年发病率从1993年的13.6%上升至2000年的21.4%。沙眼衣原体感染的年发病率相对稳定。8年期间细菌性阴道病、沙眼衣原体感染和动弯杆菌属感染的患病率分别为18.2%、4.2%和4.1%。这三种感染的患病率在青少年以及有刮宫术史的女性中显著更高。沙眼衣原体和动弯杆菌属感染的患病率在未生育史的女性中显著更高。多因素分析显示BV与产次无关。BV的月患病率在5月显著高于12月,沙眼衣原体感染的月患病率在8月较高。
BV和沙眼衣原体感染在年度和月度感染模式上的差异表明这两种感染的病因不同。