摘要
目的探析妊娠期糖尿病(GDM)孕妇妊娠晚期(>孕37周)下生殖道感染与妊娠结局的关系。方法208例妊娠晚期GDM孕妇,根据是否发生下生殖道感染分为观察组(发生下生殖道感染)和对照组(未发生下生殖道感染),各104例。检测并分析观察组感染情况,比较两组不良事件发生情况、妊娠结局。结果观察组中20例解脲支原体感染(UU)(19.23%)、14例霉菌性阴道炎(VVC)(13.46%)、58例B族链球菌感染(GBS)(55.77%)、8例细菌性阴道病(BV)(7.69%)、3例沙眼衣原体(2.88%)、1例滴虫(0.96%),其中GBS、UU占比最高。17例两种混合感染者,1例三种混合感染者。两组臀位妊娠、胎儿窘迫、羊水过少、前置胎盘、子痫前期、瘢痕子宫发生率比较,差异无统计学意义(P>0.05)。观察组胎膜早破发生率24.04%高于对照组的12.50%,差异有统计学意义(P<0.05)。观察组绒毛膜Ⅱ、Ⅲ期羊膜炎、产褥病、新生儿感染、新生儿转重症监护室(NICU)发生率分别为24.04%、8.65%、12.50%、22.12%,均高于对照组的9.62%、1.92%、4.81%、11.54%,差异有统计学意义(P<0.05)。两组新生儿高胆红素血症、新生儿窒息、小于胎龄儿、产后出血、剖宫产发生率比较,差异无统计学意义(P>0.05)。结论妊娠晚期GDM孕妇下生殖道感染原微生物中,感染UU、GBS、白色念珠菌的几率升高明显,新生儿感染、转NICU、产褥病率、胎膜早破几率增加,可改变胎盘的功能和结构,临床医生需重视防止生殖道感染,及时送检胎盘。
Objective To discuss the correlation between lower genital tract infection and pregnancy outcome in pregnant women with gestational diabetes mellitus(GDM)in late pregnancy(over 37 weeks gestation).Methods A total of 208 pregnant women with GDM in later pregnancy were divided into observation group(with lower genital tract infection)and control group(without lower genital tract infection)according to whether lower genital tract infection occurred,with 104 cases in each group.The infection of the observation group was detected and analyzed,and the occurrence of adverse events and pregnancy outcomes were compared between the two groups.Results In the observation group,there were 20 cases(19.23%)of ureaplasma urealyticum(UU)infection,14 cases(13.46%)of vulvoaginal candidasis(VVC)and 58 cases(55.77%)of group B streptococcus(GBS)infection,8 cases(7.69%)of bacterial vaginosis(BV),3 cases(2.88%)of chlamydia trachomatis,1 case(0.96%)of trichomonas,among which GBS and UU accounted for the highest proportion.There were 17 cases of mixed infection with two types of infection and 1 case of mixed infection with three types of infection.There was no statistically significant difference between the two groups in terms of incidence of breech pregnancy,fetal distress,oligohydramnios,placenta previa,preeclampsia and scarred uterus(P>0.05).The incidence of premature rupture of membranes was 24.04%in the observation group,which was higher than that of 12.50%in the control group,and the difference was statistically significant(P<0.05).The incidence of stageⅡandⅢchorioamnionitis,puerperal disease,neonatal infection,and infants transfer to intensive care unit(NICU)were 24.04%,8.65%,12.50%,and 22.12%in the observation group,which were higher than those of 9.62%,1.92%,4.81%,and 11.54%in the control group,and the differences were statistically significant(P<0.05).The differences were not statistically significant when comparing the incidence of neonatal hyperbilirubinemia,neonatal asphyxia,small for gestational age,postpartum hemorrhage,and cesarean section between the two groups(P>0.05).Among the pathogenic microorganisms of lower genital tract infectiond in GDM pregnant women in late pregnancy,the chances of infection of UU,GBS and Candida albicans increase significantly,neonatal infection,transfer to NICU,puerperal disease rate and premature rupture of membranes increase,which can change the function and structure of the placenta.Clinicians should pay attention to the prevention of genital tract infection and timely delivery of placenta for examination.
作者
施晓明
陈萱
饶靖红
SHI Xiao-ming;CHEN Xuan;RAO Jing-hong(Department of Obstetrics and Gynecology,Fujian Medical University Affiliated Quanzhou First Hospital,Quanzhou 362000,China)
出处
《中国现代药物应用》
2023年第13期57-60,共4页
Chinese Journal of Modern Drug Application
关键词
生殖道感染
妊娠结局
妊娠期糖尿病
混合感染
Genital tract infection
Pregnancy outcome
Gestational diabetes mellitus
Mixed infection
