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性交频率、宫颈长度和泌尿生殖系统感染之间的相互作用会影响产科结局吗?

Do the interactions between coital frequency, cervical length, and urogenital infection affect obstetric outcomes?

作者信息

Çakıroğlu Yiğit, Çalışkan Şeyda, Doğer Emek, Yıldırım Köpük Şule, Dündar Devrim, Çalışkan Eray

机构信息

Kocaeli University Faculty of Medicine, Department of Obstetrics and Gynecology, Kocaeli, Turkey.

Sakarya University Faculty of Medicine Education and Research Hospital, Department of Clinical Microbiology, Sakarya, Turkey.

出版信息

Turk J Obstet Gynecol. 2015 Jun;12(2):66-70. doi: 10.4274/tjod.89106. Epub 2015 Jun 15.

Abstract

OBJECTIVE

To determine whether interactions between coital frequency, cervical length, and urogenital infection affect obstetric outcomes.

MATERIALS AND METHODS

A total of 268 unselected pregnant women were recruited in the study. The study population consisted of four groups of women: group 1 (n=203) screened negative for bacterial vaginosis (BV) both in the first and second trimesters; group 2 (n=18) screened negative for BV in the first trimester but positive in the second trimester; group 3 (n=33) screened positive for BV in the first trimester but negative in the second trimester; and group 4 (n=14) screened positive for BV both in the first and second trimesters. Urine culture, cervico-vaginal cultures, and bacterial vaginosis were screened between 11-14 weeks and 20-24 weeks.

RESULTS

Two hundred fifty women were eligible for analysis in the study after lost-to-follow up patients were excluded. Previous abortion ≥1 and previous preterm delivery at 24-34 weeks ≥1 were statistically significantly higher in group 2. The number of patients who were diagnosed as having preterm premature rupture of membranes (PPROM) was statistically significantly higher in group 4. Sexual intercourse during the first trimester, cervical length during the second trimester, and history of preterm birth (PTB) were statistically significant risk factors for preterm birth <37 weeks (1.27; (1.12-1.44); 5.33; (1.84-15.41); 6.95; (1.58-30.54), respectively).

CONCLUSION

Presence or treatment of BV did not influence rates of PTB. The probability of PPROM would be higher in patients who are BV positive both in the first and second trimesters.

摘要

目的

确定性交频率、宫颈长度和泌尿生殖道感染之间的相互作用是否会影响产科结局。

材料与方法

本研究共纳入268名未经筛选的孕妇。研究人群包括四组女性:第1组(n = 203)在孕早期和孕中期细菌性阴道病(BV)筛查均为阴性;第2组(n = 18)在孕早期BV筛查为阴性,但在孕中期为阳性;第3组(n = 33)在孕早期BV筛查为阳性,但在孕中期为阴性;第4组(n = 14)在孕早期和孕中期BV筛查均为阳性。在孕11 - 14周和20 - 24周期间进行尿培养、宫颈阴道培养和细菌性阴道病筛查。

结果

排除失访患者后,250名女性符合本研究分析条件。第2组既往流产≥1次和既往24 - 34周早产≥1次在统计学上显著更高。第4组中被诊断为胎膜早破(PPROM)的患者数量在统计学上显著更高。孕早期性交、孕中期宫颈长度和早产史是孕37周前早产的统计学显著危险因素(分别为1.27;(1.12 - 1.44);5.33;(1.84 - 15.41);6.95;(1.58 - 30.54))。

结论

BV的存在或治疗不影响早产率。孕早期和孕中期均为BV阳性的患者发生PPROM的可能性更高。

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本文引用的文献

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Prevention of preterm parturition.预防早产。
N Engl J Med. 2014 May 8;370(19):1861. doi: 10.1056/NEJMc1402822.
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Genitourinary pathogens and preterm birth.泌尿生殖系统病原体与早产。
Curr Opin Infect Dis. 2013 Jun;26(3):219-30. doi: 10.1097/QCO.0b013e328360dc31.
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Cervical assessment by ultrasound for preventing preterm delivery.超声宫颈评估预防早产。
Cochrane Database Syst Rev. 2013 Jan 31;2013(1):CD007235. doi: 10.1002/14651858.CD007235.pub3.
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Bacterial vaginosis and preterm birth.细菌性阴道病与早产。
J Midwifery Womens Health. 2011 Nov-Dec;56(6):575-83. doi: 10.1111/j.1542-2011.2011.00086.x. Epub 2011 Sep 13.

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