Boggess Kim A, Moss Kevin, Murtha Amy, Offenbacher Steven, Beck James D
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC, USA.
Am J Obstet Gynecol. 2006 Apr;194(4):954-60. doi: 10.1016/j.ajog.2006.02.026.
The purpose of this study was to determine the risks for fetal exposure to oral pathogens and the relationship between vaginal bleeding and fetal exposure in preterm birth risk.
An analysis of prospectively collected data for the longitudinal Oral Conditions and Pregnancy Study was conducted. Maternal factors that potentially were associated with fetal exposure to oral pathogens (defined as detection of umbilical cord serum Immunoglobulin M to 1 of 5 oral pathogens) were examined, and the role of vaginal bleeding and fetal exposure to oral pathogens in preterm birth risk was explored. Preterm birth was defined as delivery at <35 weeks of gestation. An adjusted relative risk (95% CI) for fetal exposure was calculated. Adjusted hazard ratios (95% CI) were calculated for preterm birth among women whose data were stratified by the presence/absence of bleeding and/or fetal exposure to oral pathogens.
There were complete data for 661 women; 230 women (34.8%) with and 431 women (65.2%) without fetal exposure to oral pathogens. In multivariable analysis, first- or second-trimester bleeding and white race were associated significantly with fetal exposure to oral pathogens (adjusted relative risk, 1.8 [95% CI, 1.3-2.5] and 1.3 [95% CI, 1.1-1.7], respectively). The adjusted hazard ratio for preterm birth among women with first- or second-trimester bleeding and fetal exposure to oral pathogens was 6.4 (95% CI: 2.6-16.0).
Vaginal bleeding is associated with fetal exposure to oral pathogens, which increases preterm birth risk. Whether bleeding is the cause of or result of fetal exposure to oral pathogens remains to be determined.
本研究旨在确定胎儿暴露于口腔病原体的风险，以及早产风险中阴道出血与胎儿暴露之间的关系。
对前瞻性收集的纵向口腔状况与妊娠研究数据进行分析。检查了可能与胎儿暴露于口腔病原体（定义为脐带血清中检测到针对5种口腔病原体之一的免疫球蛋白M）相关的母体因素，并探讨了阴道出血和胎儿暴露于口腔病原体在早产风险中的作用。早产定义为妊娠<35周分娩。计算胎儿暴露的调整相对风险（95%CI）。对于数据按有无出血和/或胎儿暴露于口腔病原体分层的女性，计算早产的调整风险比（95%CI）。
661名女性有完整数据；230名女性（34.8%）胎儿暴露于口腔病原体，431名女性（65.2%）未暴露。在多变量分析中，孕早期或孕中期出血和白人种族与胎儿暴露于口腔病原体显著相关（调整相对风险分别为1.8[95%CI，1.3 - 2.5]和1.3[95%CI，1.1 - 1.7]）。孕早期或孕中期出血且胎儿暴露于口腔病原体的女性早产的调整风险比为6.4（95%CI：2.6 - 16.0）。
阴道出血与胎儿暴露于口腔病原体相关，这会增加早产风险。出血是胎儿暴露于口腔病原体的原因还是结果仍有待确定。
