McGregor JA, French JI
Department of Obstetrics and Gynecology, University of Colorado Health Sciences Center, Denver, Colo.
Medscape Womens Health. 1997 Aug;2(8):1.
Preterm birth is the leading preventable cause of neonatal morbidity. Evidence shows that common genitourinary infections, which can easily be treated, cause large numbers of babies to be born prematurely. Because of their biologically immature organs, these newborns require intensive neonatal care, which leads to excess hospital costs early in life (approximately $3000/day at the University of Colorado). Long term, these children require follow-up for a range of disabling conditions, such as cerebral palsy, mental retardation, blindness, and/or deafness. Inexpensive screening during pregnancy can detect such common infections as bacterial vaginosis, trichomoniasis, chlamydia, and urinary tract infection; prompt treatment of these infections can effectively reduce admissions for preterm labor evaluation and can lower preterm birth rates. Bacterial vaginosis, in particular, has been consistently associated with a significantly increased risk of preterm births. Selective use of antibiotics in women during preterm labor and premature rupture of membranes significantly reduces both preterm birth rates and the risk of complications--in particular, from group B streptococcus (GBS) infection--in both babies and mothers. Implementation of appropriate screening and treatment of bacterial vaginosis and other prevalent infections can dramatically reduce the excess morbidity and mortality of infants "born too soon" because of reproductive tract infection.
早产是新生儿发病的主要可预防原因。有证据表明，常见的泌尿生殖系统感染虽然易于治疗，但却导致大量婴儿早产。由于这些新生儿的器官在生理上尚未发育成熟，他们需要重症新生儿护理，这导致了生命早期的医院费用过高（科罗拉多大学约为每天3000美元）。长期来看，这些儿童需要针对一系列致残状况进行随访，如脑瘫、智力迟钝、失明和/或失聪。孕期进行廉价筛查能够检测出细菌性阴道病、滴虫病、衣原体感染和尿路感染等常见感染；及时治疗这些感染可有效减少早产评估的入院人数，并降低早产率。特别是细菌性阴道病，一直与早产风险显著增加相关。在早产和胎膜早破期间对女性选择性使用抗生素，可显著降低早产率以及婴儿和母亲出现并发症的风险，尤其是由B族链球菌（GBS）感染引起的并发症。对细菌性阴道病和其他常见感染实施适当的筛查和治疗，可大幅降低因生殖道感染导致“过早出生”婴儿的额外发病率和死亡率。
