Saha Srishti, Pardi Ryan, Theiler Regan N, Pardi Darrell S, Khanna Sahil
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Division of Obstetrics, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN, USA.
Therap Adv Gastroenterol. 2023 Apr 27;16:17562848231170479. doi: 10.1177/17562848231170479. eCollection 2023.
The incidence of infection (CDI) in peripartum women is rising, but limited data on its effect on maternal and neonatal outcomes are available.
To study the effect of peripartum CDI on pregnancy and neonatal outcomes.
Retrospective cohort study.
Patients with peripartum CDI 12 weeks before pregnancy through 6 weeks postpartum (January 1996-February 2018) were matched with controls (peripartum women without CDI) 1:1 by age, year of delivery, and prior pregnancies. McNemar's test and conditional logistic regression were used to analyze the effect of CDI on pregnancy and neonatal outcomes (complications, mode of delivery). < 0.05 was considered statistically significant.
Overall, 101 cases and 100 controls (1997-2018) were included; median age 27 (range, 20-41) years. Timing of CDI was as follows: pre-pregnancy: 15.8% ( = 16), during pregnancy: 51.5% ( = 52), and postpartum: 32.7% ( = 33). The commonest risk factor was outpatient/emergency room visits. Pregnancy and neonatal outcomes were analyzed for 67 matched pairs with CDI before or during pregnancy. Cases had higher odds of cesarean delivery ( = 0.02) and lower odds of Group B (GBS) infection/colonization ( = 0.03). Odds of cesarean delivery remained high after controlling for labor arrest disorders [odds ratio (OR): 17.23 (95% confidence interval (CI), 2.19-543.19; = 0.004)]; odds of GBS remained low after controlling for antibiotic use (OR: 0.25, 95% CI, 0.04-0.99; = 0.049). Neonatal outcomes were similar in cases and controls. CDI treatment did not affect treatment-related or delivery outcomes.
Peripartum CDI was associated with higher odds of cesarean delivery and lower odds of GBS infections. Larger studies exploring the effect of CDI on pregnancy and neonatal outcomes are needed.
围产期女性感染（CDI）的发生率正在上升，但关于其对孕产妇和新生儿结局影响的数据有限。
研究围产期CDI对妊娠和新生儿结局的影响。
回顾性队列研究。
将1996年1月至2018年2月期间妊娠前12周直至产后6周发生围产期CDI的患者与对照组（无CDI的围产期女性）按年龄、分娩年份和既往妊娠情况进行1:1匹配。采用McNemar检验和条件逻辑回归分析CDI对妊娠和新生儿结局（并发症、分娩方式）的影响。P<0.05被认为具有统计学意义。
总体纳入了101例病例和100例对照（1997 - 2018年）；中位年龄27岁（范围20 - 41岁）。CDI发生时间如下：妊娠前：15.8%（n = 16），妊娠期：51.5%（n = 52），产后：32.7%（n = 33）。最常见的危险因素是门诊/急诊就诊。对67对妊娠前或妊娠期有CDI的匹配对进行了妊娠和新生儿结局分析。病例剖宫产的几率更高（P = 0.02），B族链球菌（GBS）感染/定植的几率更低（P = 0.03）。在控制产程停滞障碍后，剖宫产几率仍然很高[比值比（OR）：17.23（95%置信区间（CI），2.19 - 543.19；P = 0.004）]；在控制抗生素使用后，GBS感染几率仍然很低（OR：0.25，95% CI，0.04 - 0.99；P = 0.049）。病例组和对照组的新生儿结局相似。CDI治疗不影响治疗相关或分娩结局。
围产期CDI与剖宫产几率较高和GBS感染几率较低相关。需要开展更大规模的研究来探讨CDI对妊娠和新生儿结局的影响。
