Lanouette J M, Puder K S, Berry S M, Bryant D R, Dombrowski M P
Department of Obstetrics and Gynecology, Wayne State University, Detroit, Mich., USA.
Fetal Diagn Ther. 1997 Jul-Aug;12(4):244-7. doi: 10.1159/000264477.
Inflammation on Papanicolaou (Pap) smear has been associated with a 30-50% incidence of bacterial vaginosis (BV), a recognized risk factor for preterm delivery. We determined whether inflammation on Pap smear is associated with preterm delivery.
5,348 cases were studied with complete prenatal data including the potential confounder of treatment with antibiotics. Cases were categorized by presence (n = 1,139) or absence (n = 4,209) of inflammation on Pap smear.
In the inflammation group the proportion of African Americans was lower (66.9 vs. 74.5%; p < 0.001). There were no significant differences (t test) for maternal age, gravidity, history of preterm delivery, or gestational age at delivery between inflammation and noninflammation groups. Multiple stepwise regression analysis showed that maternal age, history of preterm delivery, and African American race were all significantly positively associated with preterm delivery. Treatment with metronidazole during the pregnancy was significantly negatively associated with preterm delivery. Inflammation on Pap smear, gonorrhea detected during the pregnancy and prenatal treatment with erythromycin were not associated.
Unlike bacterial vaginosis, inflammation on routine Pap smear does not appear to be a risk for subsequent preterm birth. We are unable to use inflammation on Pap smear as a surrogate for more specific diagnosis of bacterial vaginosis.
巴氏涂片检查中的炎症与30%-50%的细菌性阴道病（BV）发病率相关，细菌性阴道病是公认的早产风险因素。我们确定巴氏涂片检查中的炎症是否与早产相关。
对5348例病例进行研究，这些病例具有完整的产前数据，包括抗生素治疗这一潜在混杂因素。根据巴氏涂片检查中有无炎症将病例分为两组，有炎症组（n = 1139）和无炎症组（n = 4209）。
炎症组中非洲裔美国人的比例较低（66.9%对74.5%；p < 0.001）。炎症组和无炎症组在产妇年龄、妊娠次数、早产史或分娩时的孕周方面无显著差异（t检验）。多因素逐步回归分析显示，产妇年龄、早产史和非洲裔美国人种族均与早产显著正相关。孕期使用甲硝唑治疗与早产显著负相关。巴氏涂片检查中的炎症、孕期检测到的淋病和产前使用红霉素治疗均与早产无关。
与细菌性阴道病不同，常规巴氏涂片检查中的炎症似乎不是随后早产的风险因素。我们不能将巴氏涂片检查中的炎症作为细菌性阴道病更具体诊断的替代指标。
