Aly Hany, Alhabashi Galeb, Hammad Tarek A, Owusu-Ansah Sylvia, Bathgate Susanne, Mohamed Mohamed
Department of Pediatrics, George Washington University, Washington, DC; Department of Obstetrics, George Washington University, Washington, DC, USA.
J Pediatr. 2008 Jul;153(1):16-8. doi: 10.1016/j.jpeds.2008.02.008. Epub 2008 Apr 3.
To examine risk factors associated with chorioamnionitis.
We conducted a retrospective cohort study using data on women who delivered prematurely (< 37 weeks of gestation) over a 12-year period. Eleven potential risk factors were identified. Subjects were stratified according to their blood type into 2 groups: group 1, subjects with anti-B antibodies (blood types A and O), and group 2, subjects without anti-B antibodies (blood types B and AB). Univariate, bivariate, and logistic regression analyses were done to examine risk factors for chorioamnionitis while controlling for confounders.
The study included 2879 subjects, 96 of whom (3.3%) were diagnosed with chorioamnionitis. Chorioamnionitis increased significantly with alcohol use (adjusted odds ratio [AOR] = 4.7), prolonged rupture of membranes (ROM) (AOR = 4.16), anemia (AOR = 2.17), and group 1 status (AOR = 1.88). Advanced maternal age was protective of chorioamnionitis (AOR = 0.96).
Alcohol consumption during pregnancy, prolonged ROM, anemia, and blood types A and O are associated with increased risk for chorioamnionitis; advanced maternal age, with decreased risk. Further studies are needed to determine the efficacy of early prenatal care in the control of anemia and to examine its affect on the incidence of chorioamnionitis.
研究与绒毛膜羊膜炎相关的危险因素。
我们进行了一项回顾性队列研究,使用了12年间早产(孕周<37周)女性的数据。确定了11个潜在危险因素。根据血型将受试者分为2组:第1组,有抗B抗体的受试者(A型和O型血),第2组,无抗B抗体的受试者(B型和AB型血)。在控制混杂因素的同时,进行单因素、双因素和逻辑回归分析以研究绒毛膜羊膜炎的危险因素。
该研究纳入2879名受试者,其中96名(3.3%)被诊断为绒毛膜羊膜炎。绒毛膜羊膜炎与饮酒(调整优势比[AOR]=4.7)、胎膜早破(PROM)延长(AOR=4.16)、贫血(AOR=2.17)以及第1组状态(AOR=1.88)显著相关。高龄产妇对绒毛膜羊膜炎有保护作用(AOR=0.96)。
孕期饮酒、胎膜早破延长、贫血以及A型和O型血与绒毛膜羊膜炎风险增加相关;高龄产妇则风险降低。需要进一步研究以确定早期产前护理在控制贫血方面的效果,并检查其对绒毛膜羊膜炎发病率的影响。