细菌性阴道病、滴虫性阴道炎及阴道酸度与妊娠结局的关联

Association of bacterial vaginosis, trichomonas vaginalis, and vaginal acidity with outcome of pregnancy.

作者信息

Azargoon Azam, Darvishzadeh Shohreh

机构信息

Department of Obstetrics and Gynecology, Vali-e-Asr Reproductive Health Research Center, Keshavarz Blvd., Tehran 14194, Iran.

出版信息

Arch Iran Med. 2006 Jul;9(3):213-7.

PMID:16859053

Abstract

BACKGROUND

Bacterial vaginosis and Trichomons vaginalis are believed to be the risk factors for preterm labor birth and preterm prelabor rupture of membranes. The objective of this study was to investigate the association between bacterial vaginosis, T.vaginalis, and vaginal pH with preterm labor birth and preterm prelabor rupture of membranes after excluding other known risk factors.

METHODS

In this cohort study, we enrolled 1223 pregnant women with gestational age of 16 - 36 weeks from Amir-Almomenin General Hospital in Semnan, Iran, who had no known medical risk factors for preterm labor birth. Bacterial vaginosis and T.vaginalis were determined on the basis of vaginal pH, saline wet mount, and Amsel tests. The principal outcome was delivery before 37 weeks of gestation and preterm prelabor rupture of membranes.

RESULTS

Bacterial vaginosis and T.vaginalis were detected in 16.0% and 5.5% of these women, respectively. Bacterial vaginosis was positive in 65 (33.1%) patients at 16 - 20 weeks of gestation and in 134 (66.9%) patients at 36 weeks of gestation or during labor (developing preterm labor birth or preterm prelabor rupture of membranes). The frequencies for T.vaginalis were 20 (29.9%) and 47 (70.1%) patients, respectively. All patients with bacterial vaginosis and T.vaginalis had a vaginal pH > or = 5. There was a significant correlation between bacterial vaginosis and vaginal pH > or = 5, with preterm labor birth (OR: 5.99; CI: 3.79 - 9.49) and preterm prelabor rupture of membranes (OR: 2.34; CI: 1.07 - 4.99). Moreover, a significant correlation was found between vaginal pH > or = 5 with preterm labor birth (OR: 5.82; CI: 2.96 - 11.39) and preterm prelabor rupture of membranes (OR: 4.11; CI: 1.62 - 10.12). There was no significant correlation between T.vaginalis with preterm labor birth (OR: 0.73; CI: 0.22 - 2.17) and preterm prelabor rupture of membranes (OR: 1.22; CI: 0.29 - 5.05).

CONCLUSION

The presence of bacterial vaginosis or vaginal pH > or = 5 at 16 - 36 weeks of gestation is associated with an increased risk of preterm labor birth and preterm prelabor rupture of membranes.

摘要

背景

细菌性阴道病和滴虫性阴道炎被认为是早产和胎膜早破的危险因素。本研究的目的是在排除其他已知危险因素后，调查细菌性阴道病、阴道毛滴虫及阴道pH值与早产和胎膜早破之间的关联。

方法

在这项队列研究中，我们纳入了1223名来自伊朗塞姆南阿米尔 - 阿尔莫门宁综合医院、孕周为16 - 36周且无已知早产医学危险因素的孕妇。根据阴道pH值、生理盐水湿片检查和阿姆斯勒试验来确定细菌性阴道病和阴道毛滴虫。主要结局是妊娠37周前分娩和胎膜早破。

结果

这些女性中分别有16.0%和5.5%检测出细菌性阴道病和阴道毛滴虫。妊娠16 - 20周时，65名（33.1%）患者细菌性阴道病呈阳性；妊娠36周或分娩时（发生早产或胎膜早破），134名（66.9%）患者细菌性阴道病呈阳性。阴道毛滴虫检测呈阳性的患者分别为20名（29.9%）和47名（70.1%）。所有患有细菌性阴道病和阴道毛滴虫的患者阴道pH值均≥5。细菌性阴道病以及阴道pH值≥5与早产（比值比：5.99；可信区间：3.79 - 9.49）和胎膜早破（比值比：2.34；可信区间：1.07 - 4.99）之间存在显著相关性。此外，阴道pH值≥5与早产（比值比：5.82；可信区间：2.96 - 11.39）和胎膜早破（比值比：4.11；可信区间：1.62 - 10.12）之间也存在显著相关性。阴道毛滴虫与早产（比值比：0.73；可信区间：0.22 - 2.17）和胎膜早破（比值比：1.22；可信区间：0.29 - 5.05）之间无显著相关性。