Laibl Vanessa R, Sheffield Jeanne S, Roberts Scott, McIntire Donald D, Wendel George D
Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75390-9032, USA.
Obstet Gynecol. 2006 Dec;108(6):1493-7. doi: 10.1097/01.AOG.0000247647.88489.b0.
To establish the role of clinical chorioamnionitis as an independent risk factor for recurrence in a subsequent pregnancy.
This was a historical cohort study of pregnant women who had their first and second deliveries at our institution between January 1988 and May 2005. The index pregnancy was restricted to those who delivered vaginally. Data were collected from a continuously updated obstetric database and included demographic and labor characteristics and neonatal outcomes. Chorioamnionitis was diagnosed clinically.
The study population consisted of 23,397 women. During the index pregnancy, 10% of women developed chorioamnionitis. This group was significantly different from the rest of the cohort in terms of age, ethnicity, length of labor, epidural analgesia, use of internal monitors, and incidence of prolonged rupture of membranes. In the second pregnancy, 6% of those women again developed chorioamnionitis compared with 2% of women who did not have chorioamnionitis in the first pregnancy (odds ratio 2.93, 95% confidence interval 2.40-3.57). After adjusting for the above confounders, the increased risk of recurrence persisted (odds ratio 1.85, 95% confidence interval 1.49-2.30).
Women delivering vaginally who were diagnosed with chorioamnionitis during their first pregnancy are at increased risk for chorioamnionitis in a subsequent pregnancy. This supports the concept that there may be a predisposition to chorioamnionitis that should be further investigated.
II-2.
确定临床绒毛膜羊膜炎作为后续妊娠复发的独立危险因素的作用。
这是一项对1988年1月至2005年5月在我们机构进行首次和第二次分娩的孕妇的历史性队列研究。索引妊娠仅限于经阴道分娩的孕妇。数据从不断更新的产科数据库中收集，包括人口统计学和分娩特征以及新生儿结局。绒毛膜羊膜炎通过临床诊断。
研究人群包括23397名女性。在索引妊娠期间，10%的女性发生了绒毛膜羊膜炎。该组在年龄、种族、产程长度、硬膜外镇痛、使用内部监护仪以及胎膜早破发生率方面与队列中的其他人群有显著差异。在第二次妊娠中，这些女性中有6%再次发生绒毛膜羊膜炎，而第一次妊娠未发生绒毛膜羊膜炎的女性中这一比例为2%（比值比2.93，95%置信区间2.40 - 3.57）。在对上述混杂因素进行调整后，复发风险增加仍然存在（比值比1.85，95%置信区间1.49 - 2.30）。
首次妊娠期间经阴道分娩且被诊断为绒毛膜羊膜炎的女性在后续妊娠中发生绒毛膜羊膜炎的风险增加。这支持了可能存在绒毛膜羊膜炎易感性这一概念，应进一步研究。
II - 2。
