Atterbury J L, Groome L J, Baker S L, Ross E L, Hoff C
Department of Obstetrics and Gynecology, University of South Alabama, Mobile, USA.
J Matern Fetal Med. 1998 Sep-Oct;7(5):250-4. doi: 10.1002/(SICI)1520-6661(199809/10)7:5<250::AID-MFM9>3.0.CO;2-I.
This study identified risk factors associated with readmission for postpartum endometritis. The study group consisted of 109 mothers (Group I) who were discharged after delivery and readmitted with endometritis. Control groups consisted of women who had endometritis immediately after delivery but who did not require readmission (Group II, n = 109), and women who had no intrapartum or puerperal infection and also were not readmitted (Group III, n = 109). Subjects in Groups II and III were matched to an index study subject for date of delivery and maternal age, race, and parity; and women in Groups I and III were also matched for route of delivery. Groups were compared in terms of demographic characteristics, intrapartum course, and clinical presentation. The data were analyzed with the t-test, chi2, and multiple logistic regression analyses, and a P value < .05 was considered significant. Women in Groups I and III delivered vaginally more often than mothers in Group II. In addition, mothers in Groups I and III had similar postpartum courses, no evidence of infection on discharge after delivery, and a similar period from delivery until postpartum discharge. Although women in Group I were more likely to have spontaneous rupture of membranes, a shorter latent period, and have fewer bilateral tubal ligations than mothers in Group II, multivariate analysis identified route of delivery as the only significant maternal variable associated with postpartum endometritis requiring readmission. Women who were readmitted for endometritis usually delivered vaginally, and the occurrence of late-onset postpartum endometritis was unrelated to the length of stay following delivery.
本研究确定了与产后子宫内膜炎再次入院相关的危险因素。研究组由109名母亲组成（第一组），她们在分娩后出院，随后因子宫内膜炎再次入院。对照组包括分娩后立即患有子宫内膜炎但无需再次入院的女性（第二组，n = 109），以及没有产时或产褥期感染且也未再次入院的女性（第三组，n = 109）。第二组和第三组的受试者在分娩日期、产妇年龄、种族和胎次方面与一名索引研究对象进行匹配；第一组和第三组的女性在分娩方式上也进行了匹配。对各组的人口统计学特征、产时过程和临床表现进行了比较。数据采用t检验、卡方检验和多元逻辑回归分析进行分析，P值<0.05被认为具有统计学意义。第一组和第三组的女性经阴道分娩的频率高于第二组的母亲。此外，第一组和第三组的母亲产后过程相似，分娩后出院时无感染迹象，从分娩到产后出院的时间也相似。尽管第一组的女性比第二组的母亲更有可能发生胎膜早破、潜伏期更短且双侧输卵管结扎较少，但多因素分析确定分娩方式是与需要再次入院的产后子宫内膜炎相关的唯一显著母体变量。因子宫内膜炎再次入院的女性通常经阴道分娩，迟发性产后子宫内膜炎的发生与分娩后的住院时间无关。
