Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
Am J Obstet Gynecol. 2011 Apr;204(4):342.e1-5. doi: 10.1016/j.ajog.2010.11.003. Epub 2010 Dec 22.
The purpose of this study was to estimate the effect of bacterial vaginosis on midtrimester cervical length in women at increased risk for recurrent spontaneous preterm birth.
We conducted a secondary analysis of prerandomization data from a multicenter trial of ultrasound-indicated cerclage. Women with previous spontaneous preterm birth at <34 weeks' gestation underwent initial cervical length assessment and vaginal fluid collection at 16-21 weeks 6 days gestation. Gram stains were scored with Nugent criteria. With serial scans, the shortest cervical length was observed.
Records for 949 women had complete data. In unadjusted regression models, Nugent score (P = .003) and vaginal fluid pH (P = .008) were related inversely to cervical length. Women with bacterial vaginosis based on Nugent score ≥7 (P = .04) or pH ≥5 (P = .016) had significantly lower cervical length than unaffected women; however, all of these effects were null after covariate adjustment.
Nugent score, pH level, and bacterial vaginosis are associated inversely with cervical length; however, these relationships become null after adjustment for relevant covariates.
本研究旨在评估细菌性阴道病对复发性自发性早产高危孕妇中孕期宫颈长度的影响。
我们对一项超声指征性宫颈环扎术多中心试验的随机前数据进行了二次分析。妊娠 16-21 周 6 天时，有妊娠 34 周前自发性早产史的女性进行初始宫颈长度评估和阴道液采集。革兰氏染色采用 Nugent 标准评分。通过连续扫描观察最短的宫颈长度。
949 名女性的记录有完整数据。在未调整的回归模型中，Nugent 评分（P =.003）和阴道液 pH 值（P =.008）与宫颈长度呈负相关。根据 Nugent 评分≥7（P =.04）或 pH 值≥5（P =.016）诊断为细菌性阴道病的女性与未受影响的女性相比，宫颈长度显著较短；然而，在调整了相关协变量后，所有这些影响均变为无效。
Nugent 评分、pH 值和细菌性阴道病与宫颈长度呈负相关；然而，在调整了相关协变量后，这些关系变为无效。
