巴西维多利亚市一家大学医院中产妇沙眼衣原体感染与早产情况
Maternal Chlamydia trachomatis Infections and Preterm Births in a University Hospital in Vitoria, Brazil.
作者信息
Schmidt Renylena, Muniz Renan Rosetti, Cola Elizandra, Stauffert Dulce, Silveira Mariangela Freitas, Miranda Angelica E
机构信息
Programa de Pós-Graduação em Doenças Infecciosas, Universidade Federal do Espirito Santo, Vitoria, Brasil.
Departamento Materno Infantil, Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Brasil.
出版信息
PLoS One. 2015 Oct 27;10(10):e0141367. doi: 10.1371/journal.pone.0141367. eCollection 2015.
BACKGROUND
Preterm birth (PTB) is a major determinant of neonatal morbimortality with adverse consequences for health. The causes are multifactorial, with intrauterine infection probably explaining most of these outcomes. It is believed that infection with Chlamydia trachomatis (CT) is also involved in PTB and premature rupture of membranes.
OBJECTIVES
To evaluate the prevalence of and associated factors for CT among cases of PTB attended at a University Hospital in Vitoria, Brazil.
METHODS
A cross-sectional study performed among parturient who had preterm birth from June 2012 to August 2013 in Vitoria, Brazil. Participants answered a questionnaire including demographic, behavioral, and clinical data. A sample of urine was collected and screened for CT using polymerase chain reaction. Chi-square tests were used for proportion differences and Student's-t tests and variance analysis were used for testing differences between mean values. Odds ratio was used as a measure of association with a 95% confidence interval.
RESULTS
The prevalence of PTB during the period of the study was 26% and the prevalence of CT among them was 13.9%. A total of 31.6% pregnant women were younger than 25 years old and women infected by CT were even younger than women not infected by CT (p = 0.022). Most of them (76.2%) were married or had a living partner, and CT infection was more frequent among the single ones (p = 0.018); 16.7% of women reported their first sexual intercourse under 14 years old. The causes of prematurity were maternal-fetal in 40.9%; rupture of the membranes in 29.7% and premature labor in 29.4%. In multivariate analysis, being married was a protective factor for infection [OR = 0.48 (95%CI:0.24-0.97)]. None of the other characteristics were associated with CT infection.
CONCLUSIONS
This study shows a high prevalence of CT infection among parturient who have preterm birth. This high prevalence highlight the need for defining screening strategies focused on young pregnant women in Brazil.
背景
早产是新生儿发病和死亡的主要决定因素，对健康有不良影响。其病因是多因素的，宫内感染可能是这些结果的主要原因。据信，沙眼衣原体（CT）感染也与早产和胎膜早破有关。
目的
评估巴西维多利亚市一家大学医院收治的早产病例中CT的患病率及相关因素。
方法
对2012年6月至2013年8月在巴西维多利亚市早产的产妇进行横断面研究。参与者回答了一份包括人口统计学、行为学和临床数据的问卷。收集尿液样本，采用聚合酶链反应筛查CT。卡方检验用于比例差异检验，学生t检验和方差分析用于检验均值差异。比值比用作关联度量，置信区间为95%。
结果
研究期间早产的患病率为26%，其中CT的患病率为13.9%。共有31.6%的孕妇年龄小于25岁，感染CT的女性比未感染CT的女性更年轻（p = 0.022）。她们中的大多数（76.2%）已婚或有同居伴侣，单身女性中CT感染更为常见（p = 0.018）；16.7%的女性报告首次性交年龄在14岁以下。早产的原因中，母婴因素占40.9%；胎膜破裂占29.7%，早产占29.4%。多因素分析显示，已婚是感染的保护因素[比值比 = 0.48（95%置信区间：0.24 - 0.97）]。其他特征均与CT感染无关。
结论
本研究表明早产产妇中CT感染的患病率较高。这一高患病率凸显了在巴西制定针对年轻孕妇的筛查策略的必要性。
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