Baer Rebecca J, Nidey Nichole, Bandoli Gretchen, Chambers Brittany D, Chambers Christina D, Feuer Sky, Karasek Deborah, Oltman Scott P, Rand Larry, Ryckman Kelli K, Jelliffe-Pawlowski Laura L
Department of Pediatrics, University of California San Diego, La Jolla, California.
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.
AJP Rep. 2021 Jan;11(1):e5-e14. doi: 10.1055/s-0040-1721668. Epub 2021 Jan 13.
The aim of the study is to evaluate the risk of preterm birth (PTB, <37 weeks) and early term (37 and 38 weeks) birth among women with an emergency department (ED) visit or hospitalization with a urinary tract infection (UTI) by trimester of pregnancy. The primary sample was selected from births in California between 2011 and 2017. UTIs were identified from the ED or hospital discharge records. Risk of PTB, by subtype, and early term birth were evaluated by trimester of pregnancy and by type of visit using log-linear regression. Risk ratios were adjusted for maternal factors. Antibiotic usage was examined in a population of privately insured women from Iowa. Women with a UTI during pregnancy were at elevated risk of a birth <32 weeks, 32 to 36 weeks, and 37 to 38 weeks (adjusted risk ratios [aRRs] 1.1-1.4). Of the women with a diagnostic code for multiple bacterial species, 28.8% had a PTB. A UTI diagnosis elevated risk of PTB regardless of antibiotic treatment (aRR 1.4 for treated, aRR 1.5 for untreated). UTIs are associated with early birth. This association is present regardless of the trimester of pregnancy, type of PTB, and antibiotic treatment.
本研究的目的是评估因尿路感染（UTI）而前往急诊科就诊或住院的孕妇发生早产（PTB，<37周）和早期足月产（37和38周）的风险，并按孕期进行分类。主要样本选自2011年至2017年加利福尼亚州的出生记录。通过急诊科或医院出院记录来识别尿路感染。使用对数线性回归按孕期和就诊类型评估早产（按亚型）和早期足月产的风险。风险比率根据孕产妇因素进行了调整。对爱荷华州有私人保险的女性群体中的抗生素使用情况进行了检查。孕期发生尿路感染的女性在孕<32周、32至36周以及37至38周时分娩的风险升高（调整风险比率[aRRs]为1.1 - 1.4）。在有多种细菌种类诊断代码的女性中，28.8%发生了早产。无论是否接受抗生素治疗，尿路感染诊断都会增加早产风险（接受治疗的aRR为1.4，未接受治疗的aRR为1.5）。尿路感染与早产有关。无论孕期、早产类型和抗生素治疗情况如何，这种关联都存在。
