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[细菌性阴道病是早产的危险因素吗?对阿拉斯医院1336例患者的队列研究]

[Is the bacterial vaginosis risk factor of prematurity? Study of a cohort of 1336 patients in the hospital of Arras].

作者信息

Bothuyne-Queste E, Hannebicque-Montaigne K, Canis F, Noulard M-N, Plennevaux J-L, Tilloy E, Subtil D

机构信息

Maternité, centre hospitalier d'Arras, boulevard Georges-Besnier, Arras, France.

出版信息

J Gynecol Obstet Biol Reprod (Paris). 2012 May;41(3):262-70. doi: 10.1016/j.jgyn.2012.01.007. Epub 2012 Feb 28.

Abstract

BACKGROUND

Among risk factors of prematurity, bacterial vaginosis (BV) could play an important role, but few studies took place in our country.

AIM

In a French population of women booking in a hospital maternity, to search a link between prematurity and BV in the first trimester of pregnancy.

METHODS

A hospital cohort study was carried out between May 2006 and September 1(st), 2009. Pregnant women were screening for BV before 13+6 weeks' gestation. BV was determined by a Gram-Stained Vaginal score greater or equal to 7.

RESULTS

One thousand three hundred and thirty-six patients were included in the study among whom 203 patients had BV and 1133 patients did not have. The presence of BV was significantly associated with preterm delivery (OR: 1.6; 95% IC: 1.1-2.7). But this increase concerned only the spontaneous prematurity (ORa: 1.8, 95% IC: 1.0-3.2) and the statistical association disappeared after taking into account maternal tobacco addiction and socio-economic weak level (ORa: 1.6; 95% IC: 0.9-2.9). At the patient with BV, moreover, the risk of miscarriage before 16SA was significantly augmented at the patient with BV (OR: 3.4; 95% IC: 1.1-10.4), but this risk disappeared after taking into account tobacco addiction and maternal level of studies (ORa: 1.9; 95% IC: 0.5-7.2).

CONCLUSION

The presence of BV in the first trimester of pregnancy seems to be associated with increased risks of preterm delivery and early spontaneous miscarriage. However, this relation seems to be partly linked to a level of weaker study and a more frequent tobacco addiction among the women with BV.

摘要

背景

在早产的危险因素中,细菌性阴道病(BV)可能起重要作用,但我国对此研究较少。

目的

在法国一家医院产科登记的女性人群中,探寻妊娠早期早产与BV之间的联系。

方法

于2006年5月至2009年9月1日进行了一项医院队列研究。在妊娠13+6周之前对孕妇进行BV筛查。通过革兰氏染色阴道评分大于或等于7来确定BV。

结果

1336例患者纳入研究,其中203例患有BV,1133例未患。BV的存在与早产显著相关(比值比:1.6;95%可信区间:1.1 - 2.7)。但这种增加仅涉及自然早产(调整后比值比:1.8,95%可信区间:1.0 - 3.2),在考虑产妇吸烟成瘾和社会经济水平较低因素后,统计学关联消失(调整后比值比:1.6;95%可信区间:0.9 - 2.9)。此外,对于患有BV的患者,妊娠16周前流产的风险在患有BV的患者中显著增加(比值比:3.4;95%可信区间:1.1 - 10.4),但在考虑吸烟成瘾和产妇教育水平因素后,这种风险消失(调整后比值比:1.9;95%可信区间:0.5 - 7.2)。

结论

妊娠早期BV的存在似乎与早产和早期自然流产风险增加有关。然而,这种关系似乎部分与BV女性中较低的教育水平和更频繁的吸烟成瘾有关。

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