Roero Sofia, Benedetto Giulia, Charrier Lorena, Ingala Agata, Ronco Alice, Fea Teresa, Borgarello Valentina, Bossotti Carlotta, Arduino Silvana, Revelli Alberto
Twin Pregnancy Care Unit, Gynecology and Obstetrics 2U, A.O.U. Città della Salute e della Scienza, Sant'Anna Hospital, University of Turin (Department of Surgical Sciences), Via Ventimiglia 1, 10126 Turin, Italy.
Departement of Public Health and Pediatrics, A.O.U. Città della Salute e della Scienza, University of Turin, Via Santena 5, 10126 Turin, Italy.
J Clin Med. 2024 May 2;13(9):2673. doi: 10.3390/jcm13092673.
: Twin pregnancy implies a higher risk of preterm birth and, consequently, higher neonatal morbidity and mortality. In singleton pregnancies, infections of the lower genital tract (LGTIs) and bacterial vaginosis are associated with preterm labor, and their early detection has been proven effective in reducing complications like the preterm premature rupture of membranes (pPROM) and preterm delivery. The same evidence, however, is lacking for twin pregnancies. This study aimed to evaluate whether the early identification and treatment of LGTIs or bacterial vaginosis in asymptomatic women with twin pregnancy could reduce the rate of miscarriages, pPROM, and preterm birth. : This study performed a retrospective comparison of 285 women with a multiple pregnancy submitted for a cervico-vaginal swab only at 20-22 weeks (Single Test Group, STG), and 199 women who underwent the swab at 12-14 and again at 20-22 weeks (Double Test Group, DTG). All women included in the study had a twin pregnancy and were followed up at Sant'Anna Hospital, Turin (Italy), between September 2012 and February 2021. : In STG, 21.7% of patients had a positive swab; in DTG, 19.9% had an early positive swab that was immediately treated by targeted antibiotics; and 16.7% had a mid-pregnancy positive swab. The DTG showed a significantly lower incidence of pPROM in univariate analysis (14.4% vs. 23.1%, = 0.021), which was confirmed by multivariate analysis (OR 0.55, CI 0.33-0.93, = 0.025). : Our study suggests that, in asymptomatic women with twin pregnancy, the early screening of LGTIs and bacterial vaginosis by a cervico-vaginal swab at 12-14 weeks of gestational age is effective in reducing the risk of pPROM.
双胎妊娠意味着早产风险更高，因此新生儿发病率和死亡率也更高。在单胎妊娠中，下生殖道感染（LGTIs）和细菌性阴道病与早产相关，早期检测已被证明可有效减少胎膜早破（pPROM）和早产等并发症。然而，双胎妊娠缺乏同样的证据。本研究旨在评估对无症状双胎妊娠女性进行LGTIs或细菌性阴道病的早期识别和治疗是否可降低流产、pPROM和早产率。 本研究对285例仅在孕20 - 22周进行宫颈阴道拭子检查的多胎妊娠女性（单检组，STG）和199例在孕12 - 14周及20 - 22周均进行拭子检查的女性（双检组，DTG）进行了回顾性比较。纳入研究的所有女性均为双胎妊娠，于2012年9月至2021年2月在意大利都灵的圣安娜医院接受随访。 在STG中，21.7%的患者拭子检查呈阳性；在DTG中，19.9%的患者早期拭子检查呈阳性并立即接受了针对性抗生素治疗，16.7%的患者在孕中期拭子检查呈阳性。DTG在单因素分析中显示pPROM的发生率显著较低（14.4%对23.1%，P = 0.021），多因素分析证实了这一点（OR 0.55，CI 0.33 - 0.93，P = 0.025）。 我们的研究表明，对于无症状双胎妊娠女性，在孕12 - 14周通过宫颈阴道拭子对LGTIs和细菌性阴道病进行早期筛查可有效降低pPROM的风险。
