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有氧运动性阴道炎是否会对妊娠结局产生不良影响?一项前瞻性观察研究。

Does Aerobic Vaginitis Have Adverse Pregnancy Outcomes? Prospective Observational Study.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Department of Obstetrics and Gynecology, Bugshan Hospital, Jeddah, Saudi Arabia.

出版信息

Infect Dis Obstet Gynecol. 2020 Jan 18;2020:5842150. doi: 10.1155/2020/5842150. eCollection 2020.

Abstract

BACKGROUND

Aerobic vaginitis (AV) is an aberration within the balanced vaginal microbiota. Only few reports have documented the adverse pregnancy outcomes related to AV. Nonetheless, the exact role of AV in pregnancy and the potential benefit of its screening need further study. Our goal was to evaluate the association between aerobic vaginitis (AV) in late pregnancy and maternal and neonatal outcomes.

METHODS

In this prospective observational study, a total of 600 singleton pregnant women with intact fetal membranes at a gestational age of 34-36 weeks were recruited (one hundred women with AV and 500 pregnant women without AV). The study protocol excluded patients with other forms of vaginal infection. Pregnancy outcomes were traced and documented. The primary outcome was the association between AV and preterm labor. The current study compared the maternal and neonatal outcomes among pregnant women with and without AV in unadjusted and adjusted analyses with the odds ratio (OR) and 95% confidence interval (CI) reported.

RESULTS

There was an association between AV and with preterm birth (adjusted OR 3.06, 95% CI 1.58-5.95) and prelabor rupture of membranes (adjusted OR 6.17, 95% CI 3.24-11.7). For neonatal outcomes, AV was associated with a higher incidence of neonatal ICU admission (adjusted OR 2.19, 95% CI 1.1-4.34). Severe forms of AV significantly increased the incidence of PTB ( = 0.0014) and PROM ( = 0.0094) when compared to less severe forms of AV.

CONCLUSION

AV is common in late pregnancy and is linked to a diversity of adversative pregnancy outcomes including preterm birth, PROM, and neonatal ICU admission. Moreover, the incidence of PTB and PROM might further increase with the severity of AV. Clinicians should pay more consideration to vaginal microbiota assessment during pregnancy.

摘要

背景

需氧性阴道炎(AV)是阴道微生物菌群平衡失调的一种表现。仅有少数报道记录了与 AV 相关的不良妊娠结局。然而,AV 在妊娠中的确切作用以及筛查的潜在益处仍需要进一步研究。我们的目标是评估晚期妊娠中需氧性阴道炎(AV)与母婴结局的关系。

方法

这是一项前瞻性观察性研究,共招募了 600 名孕龄为 34-36 周、胎膜完整的单胎孕妇(100 名患有 AV,500 名孕妇未患有 AV)。该研究方案排除了患有其他形式阴道感染的患者。跟踪并记录妊娠结局。主要结局是 AV 与早产之间的关系。本研究在未调整和调整分析中比较了患有和未患有 AV 的孕妇的母婴结局,并报告了比值比(OR)和 95%置信区间(CI)。

结果

AV 与早产(调整后的 OR 3.06,95%CI 1.58-5.95)和胎膜早破(调整后的 OR 6.17,95%CI 3.24-11.7)相关。对于新生儿结局,AV 与新生儿 ICU 入院率较高相关(调整后的 OR 2.19,95%CI 1.1-4.34)。与轻度 AV 相比,重度 AV 显著增加了早产(P = 0.0014)和胎膜早破(P = 0.0094)的发生率。

结论

AV 在晚期妊娠中很常见,与多种不良妊娠结局有关,包括早产、胎膜早破和新生儿 ICU 入院。此外,随着 AV 的严重程度增加,PTB 和 PROM 的发生率可能进一步增加。临床医生在妊娠期间应更多地考虑阴道微生物群评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72b6/7201818/d5906e46ebf9/IDOG2020-5842150.001.jpg

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