沙眼衣原体、淋病奈瑟菌和阴道毛滴虫感染在荷兰助产士实践中的孕妇和男性伴侣中：患病率、危险因素和围产期结局。
Chlamydia trachomatis, Neisseria gonorrhoea, and Trichomonas vaginalis infections among pregnant women and male partners in Dutch midwifery practices: prevalence, risk factors, and perinatal outcomes.
机构信息
Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands.
出版信息
Reprod Health. 2021 Jun 26;18(1):132. doi: 10.1186/s12978-021-01179-8.
BACKGROUND
Antenatal screening for HIV, syphilis and HBV has been successfully implemented in The Netherlands, but data on other STI among pregnant women or male partners are limited. Our objectives: (i) to assess the prevalence of Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV) among pregnant women and male partners, (ii) to identify risk factors for these STI during pregnancy, and (iii) to identify adverse perinatal outcomes (APO) associated with STI.
METHODS
Cross-sectional study. Pregnant women aged ≤ 30 years (n = 548) and male partners (n = 425) were included at 30 midwifery practices during 2012-2016. Participants provided a self-collected vaginal swab (women) or urine sample (men) and completed a questionnaire. Perinatal data were derived from pregnancy cards. APO was defined as premature rupture of membranes, preterm delivery, low birthweight, stillbirth, neonatal conjunctival and respiratory infections. Data were analysed by logistic regression.
RESULTS
STI were present in 2.4% of pregnant women (CT 1.8%, NG 0.4%, TV 0.4%), and in 2.2% of male partners (CT 2.2%, NG 0.2%, TV 0%). Of young women (≤ 20 years), 12.5% had a CT infection. Prevalent STI during pregnancy was associated with female young age (≤ 20 years vs ≥ 21 years) (adjusted OR 6.52, CI 95%: 1.11-38.33), male non-Western vs Western background (aOR 9.34, CI 2.34-37.21), and female with ≥ 2 sex partners < 12 months vs 0-1 (aOR 9.88, CI 2.08-46.91). APO was not associated with STI, but was associated with female low education (aOR 3.36, CI 1.12-10.09), complications with previous newborn (aOR 10.49, CI 3.21-34.25 vs no complications) and short duration (0-4 years) of relationship (aOR 2.75, CI 1.41-5.39 vs ≥ 5 years). Small-for-gestational-age was not associated with STI, but was associated with female low education (aOR 7.81, 2.01-30.27), female non-Western background (aOR 4.41, 1.74-11.17), and both parents smoking during pregnancy (aOR 2.94, 1.01-8.84 vs both non-smoking).
CONCLUSIONS
Prevalence of STI was low among pregnant women and male partners in midwifery practices, except for CT among young women. The study could not confirm previously observed associations between STI and APO, which is probably due to low prevalence of STI, small study sample, and presumed treatment for STI.
背景
在荷兰，产前筛查艾滋病毒、梅毒和乙肝已成功实施，但有关孕妇或男性伴侣其他性传播感染（STI）的数据有限。我们的目标是：（i）评估孕妇和男性伴侣中沙眼衣原体（CT）、淋病奈瑟菌（NG）和阴道毛滴虫（TV）的流行率，（ii）确定怀孕期间这些 STI 的危险因素，以及（iii）确定与 STI 相关的不良围产期结局（APO）。
方法
横断面研究。在 2012 年至 2016 年期间，在 30 个助产士诊所纳入了 548 名年龄≤30 岁的孕妇和 425 名男性伴侣。参与者提供了自我采集的阴道拭子（女性）或尿液样本（男性），并完成了一份问卷。围产期数据来自妊娠卡片。APO 定义为胎膜早破、早产、低出生体重、死产、新生儿结膜炎和呼吸道感染。数据通过逻辑回归进行分析。
结果
STI 在 2.4%的孕妇（CT 1.8%，NG 0.4%，TV 0.4%）和 2.2%的男性伴侣（CT 2.2%，NG 0.2%，TV 0%）中存在。在年轻女性（≤20 岁）中，12.5%的人存在 CT 感染。怀孕期间的常见 STI 与女性年轻（≤20 岁 vs ≥21 岁）（调整后的 OR 6.52，95%CI：1.11-38.33）、男性非西方 vs 西方背景（aOR 9.34，2.34-37.21）以及女性在过去 12 个月内有≥2个性伴侣<12 个月与 0-1 个性伴侣（aOR 9.88，2.08-46.91）有关。APO 与 STI 无关，但与女性低教育程度（aOR 3.36，1.12-10.09）、与前一个新生儿的并发症（aOR 10.49，3.21-34.25 与无并发症）和较短的关系持续时间（0-4 年）（aOR 2.75，1.41-5.39 与≥5 年）有关。小于胎龄儿与 STI 无关，但与女性低教育程度（aOR 7.81，2.01-30.27）、女性非西方背景（aOR 4.41，1.74-11.17）以及父母双方在怀孕期间吸烟（aOR 2.94，1.01-8.84 与双方均不吸烟）有关。
结论
在助产士诊所中，孕妇和男性伴侣的 STI 流行率较低，除了年轻女性中的 CT 感染率较高。本研究未能证实之前观察到的 STI 与 APO 之间的关联，这可能是由于 STI 的流行率较低、研究样本较小以及假定的 STI 治疗所致。
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