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孕期上呼吸道感染是否会影响围产期结局?文献综述。

Does an upper respiratory tract infection during pregnancy affect perinatal outcomes? A literature review.

机构信息

Department of Obstetrics and Gynecology, Soroka University Medical Center, P.O Box 151, Beer-Sheva, Israel.

出版信息

Curr Infect Dis Rep. 2013 Apr;15(2):143-7. doi: 10.1007/s11908-013-0320-x.

Abstract

Upper respiratory tract infection (URTI) is a ubiquitous but often benign pathology most commonly of viral etiology. This review focuses on perinatal outcomes following URTI during pregnancy. Few data exist on the explicit topic of URTI and adverse perinatal outcomes. The entire URTI burden among pregnant women is not properly represented by the studies included in this review, because only those infections severe enough to warrant hospitalization have been studied. Most probably, the number of URTIs in pregnant women not requiring hospitalization is far larger, but this has yet to be quantified. Clearly, there are logistical barriers to obtaining such statistics. Severe URTI requiring hospitalization during pregnancy was noted to be associated with adverse perinatal complications. URTI was found to be positively correlated with preterm delivery (PTD; less than 37 weeks gestation), lower birth weight, and cesarean deliveries, without a significant effect on the rates of perinatal mortality or low Apgar scores. There appears to be a possible link between various infectious processes that occur during pregnancy and the outcome of a PTD. The inflammatory environment present during infection includes high levels of cytokines that are known to increase prostaglandins, which, in turn, can induce preterm birth. Further studies should evaluate whether URTI not requiring hospitalization has any effect on perinatal outcomes.

摘要

上呼吸道感染 (URTI) 是一种普遍存在但通常良性的疾病,最常见的病因是病毒。本综述重点关注妊娠期间 URTI 对围产期结局的影响。关于 URTI 和不良围产期结局的明确问题,现有数据很少。本综述中纳入的研究并未充分反映孕妇的全部 URTI 负担,因为仅研究了那些严重到需要住院治疗的感染。很可能,孕妇中无需住院治疗的 URTI 数量要大得多,但这尚未得到量化。显然,获得此类统计数据存在后勤障碍。妊娠期间需要住院治疗的严重 URTI 与不良围产期并发症相关。URTI 与早产(<37 周妊娠)、低出生体重和剖宫产分娩呈正相关,而对围产儿死亡率或低 Apgar 评分无显著影响。在怀孕期间发生的各种感染过程与 PTD 的结局之间似乎存在可能的联系。感染期间存在的炎症环境包括高水平的细胞因子,已知这些细胞因子会增加前列腺素,而前列腺素反过来又可以诱导早产。应进一步研究评估无需住院治疗的 URTI 是否会对围产期结局产生任何影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1dd5/7088837/daa11e3a6c64/11908_2013_320_Fig1_HTML.jpg

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