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孕产妇泌尿道感染:它是否与不良妊娠结局独立相关?

Maternal urinary tract infection: is it independently associated with adverse pregnancy outcome?

作者信息

Mazor-Dray Efrat, Levy Amalia, Schlaeffer Francisc, Sheiner Eyal

机构信息

Department of Internal Medicine, Faculty of Health Sciences, Soroka University Medical Center, Beer-Sheva, Israel.

出版信息

J Matern Fetal Neonatal Med. 2009 Feb;22(2):124-8. doi: 10.1080/14767050802488246.

Abstract

OBJECTIVE

This population-based study was aimed to determine whether there is an association between urinary tract infections (UTI) during pregnancy, among patients in whom antibiotic treatment was recommended, and maternal and perinatal outcome.

METHODS

A retrospective population-based study comparing all singleton pregnancies of patients with and without UTI was performed. Multiple logistic regression models were performed to control for confounders.

RESULTS

Out of 199,093 deliveries, 2.3% (n = 4742) had UTI during pregnancy and delivery. Patients with UTI had significantly higher rates of intra-uterine growth restriction (IUGR), pre-eclampsia, caesarean deliveries (CD) and pre-term deliveries (either before 34 weeks or 37 weeks of gestation). Although controlling for possible confounders such as maternal age and parity, using multivariable analyses, the significant association between UTI and IUGR, pre-eclampsia, CD and preterm deliveries persisted. In contrast, no significant differences in 5-min Apgar scores less than 7 or perinatal mortality were noted between the groups (0.6% vs. 0.6%; p = 0.782, and 1.5% vs. 1.4%; p = 0.704, respectively).

CONCLUSION

Maternal UTI is independently associated with pre-term delivery, pre-eclampsia, IUGR and CD. Nevertheless, it is not associated with increased rates of perinatal mortality compared with women without UTI.

摘要

目的

本基于人群的研究旨在确定在建议进行抗生素治疗的患者中,孕期尿路感染(UTI)与孕产妇及围产期结局之间是否存在关联。

方法

进行了一项基于人群的回顾性研究,比较了有和没有UTI的患者的所有单胎妊娠情况。采用多元逻辑回归模型来控制混杂因素。

结果

在199,093例分娩中,2.3%(n = 4742)在孕期和分娩时有UTI。患有UTI的患者发生宫内生长受限(IUGR)、先兆子痫、剖宫产(CD)和早产(妊娠34周前或37周前)的发生率显著更高。尽管通过多变量分析控制了可能的混杂因素,如产妇年龄和产次,但UTI与IUGR、先兆子痫、CD和早产之间的显著关联仍然存在。相比之下,两组之间5分钟阿氏评分低于7分或围产期死亡率无显著差异(分别为0.6%对0.6%;p = 0.782,以及1.5%对1.4%;p = 0.704)。

结论

孕产妇UTI与早产、先兆子痫、IUGR和CD独立相关。然而与没有UTI的女性相比,它与围产期死亡率增加无关。

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