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宫颈阴道拭子 Ureaplasma spp. 或其他微生物阳性与新生儿呼吸结局和死亡率的关系。

Association between maternal cervicovaginal swab positivity for Ureaplasma spp. or other microorganisms and neonatal respiratory outcome and mortality.

机构信息

Department of Pediatrics, Division Neonatology, University Hospital Antwerp, University of Antwerp, Antwerp, Belgium.

Department of Pediatrics, Division of Neonatology, Maastricht University Medical Center, Maastricht, The Netherlands.

出版信息

J Perinatol. 2021 Jun;41(6):1-11. doi: 10.1038/s41372-020-00808-7. Epub 2020 Sep 9.

Abstract

OBJECTIVE

We investigated the association between maternal cervicovaginal cultures, its antibiotic treatment, and neonatal outcome.

STUDY DESIGN

This retrospective cohort study enrolled 480 neonates born prior to 32 weeks' gestation. They were divided into groups according to maternal cervicovaginal culture results. Multivariate logistic regression analysis was used to predict neonatal outcome based on maternal culture results, adjusted for perinatal risk factors and neonatal morbidities.

RESULT

Maternal cervicovaginal Ureaplasma colonization was independently associated with bronchopulmonary dysplasia at 36 weeks (BPD) (OR 8.34; 95% CI 1.21-57.45). In neonates with and without maternal cervicovaginal Ureaplasma colonization BPD occurred in 12.3% and 3.8%, respectively. Maternal colonization with other microorganisms was associated with a higher neonatal mortality (p = 0.002), lower gestational age (p = 0.026), and birth weight (p = 0.036).

CONCLUSIONS

This study underscores the role of the maternal cervicovaginal microbiome as a predictor of neonatal outcome. Cervicovaginal Ureaplasma colonization seems not to be an innocent bystander in the multifactorial etiology of BPD.

摘要

目的

我们研究了母体宫颈阴道培养物及其抗生素治疗与新生儿结局之间的关系。

研究设计

本回顾性队列研究纳入了 480 名胎龄小于 32 周的新生儿。根据母体宫颈阴道培养结果将其分为不同组。采用多变量逻辑回归分析根据母体培养结果预测新生儿结局,并调整围产期危险因素和新生儿并发症。

结果

母体宫颈阴道脲原体定植与 36 周时的支气管肺发育不良(BPD)独立相关(OR8.34;95%CI1.21-57.45)。在有和没有母体宫颈阴道脲原体定植的新生儿中,BPD 的发生率分别为 12.3%和 3.8%。其他微生物的母体定植与较高的新生儿死亡率(p=0.002)、较低的胎龄(p=0.026)和出生体重(p=0.036)相关。

结论

本研究强调了母体宫颈阴道微生物组作为新生儿结局预测因子的作用。宫颈阴道脲原体定植似乎不是 BPD 多因素病因学中的无辜旁观者。

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