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阴道微生物群异常与妊娠结局相关:一项对737名孕妇的回顾性研究。

Abnormal vaginal flora correlates with pregnancy outcomes: A retrospective study from 737 pregnant women.

作者信息

Wang Weihong, Hao Jiatao, An Ruifang

机构信息

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2022 May;272:64-68. doi: 10.1016/j.ejogrb.2022.03.013. Epub 2022 Mar 7.

Abstract

OBJECTIVE

Abnormal vaginal flora (AVF) is a common cause of vulvovaginal symptoms in women. This study aims to investigate the prevalence of AVF in pregnant women and assess associations between diverse AVF subtypes and pregnancy outcomes.

METHODS

This study retrospectively collected clinical data of pregnant women who had vaginal flora tests (VFT) between January 2015 and December 2018 in the First Affiliated Hospital of Xi'an Jiaotong University. AVF were defined into different subtypes according to the results of VFT, including bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), aerobic bacteria (AV), cytolytic vaginosis (CV), and trichomoniasis. Pregnancy outcomes included gestational age at delivery, preterm birth (PTB), premature rupture of membranes (PROM), and infant birth weight. Student's t-test and Fisher's exact test was used for analyses using SPSS 22.0. P < 0.05 was considered as statistical significance.

RESULTS

A total of 737 pregnant women were included in this study. Pregnant women in AVF group suffered more PROM than women in normal vaginal flora (NVF) group (18.8% [33/176] vs 10.6% [32/302], P = 0.012); pregnant women with BV (31.3% [5/16] vs 10.6% [32/302], P = 0.018) and mixed vaginitis (55.6% [5/9] vs 10.6% [32/302], P = 0.001) had higher PROM rates than women in the NVF group. In addition, pregnant women in NVF and AVF groups had similar PTB rates (5.0% [15/302] vs 3.5% [32/302], P = 0.38).

CONCLUSIONS

AVF, including BV and Mixed vaginitis, augments PROM risk in pregnant women, demonstrating the need for vaginal flora examination during pregnancy.

摘要

目的

阴道微生物群异常(AVF)是女性外阴阴道症状的常见原因。本研究旨在调查孕妇中AVF的患病率,并评估不同AVF亚型与妊娠结局之间的关联。

方法

本研究回顾性收集了2015年1月至2018年12月在西安交通大学第一附属医院进行阴道微生物群检测(VFT)的孕妇的临床资料。根据VFT结果将AVF分为不同亚型,包括细菌性阴道病(BV)、外阴阴道假丝酵母菌病(VVC)、需氧菌(AV)、细胞溶解性阴道病(CV)和滴虫病。妊娠结局包括分娩孕周、早产(PTB)、胎膜早破(PROM)和婴儿出生体重。使用SPSS 22.0进行Student's t检验和Fisher精确检验分析。P < 0.05被认为具有统计学意义。

结果

本研究共纳入737名孕妇。AVF组孕妇的PROM发生率高于正常阴道微生物群(NVF)组孕妇(18.8% [33/176] 对10.6% [32/302],P = 0.012);BV孕妇(31.3% [5/16] 对10.6% [32/302],P = 0.018)和混合性阴道炎孕妇(55.6% [5/9] 对10.6% [32/302],P = 0.001)的PROM发生率高于NVF组孕妇。此外,NVF组和AVF组孕妇的PTB发生率相似(5.0% [15/302] 对3.5% [32/302],P = 0.38)。

结论

包括BV和混合性阴道炎在内的AVF会增加孕妇发生PROM的风险,表明孕期需要进行阴道微生物群检查。

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