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持续的细菌性阴道病和自发早产的风险
Yair J Blumenfeld1, Ivana Marić2, David K Stevenson2
1Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, California.
American journal of perinatology
|June 28, 2023
概括
怀孕期间持续的细菌性阴道炎 (BV),特别是持续超过一个季度或需要多次抗生素治疗时,与自发早产 (sPTB) 的风险增加有关. 这强调了监测和管理整个妊娠期间的BV的重要性.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 在怀孕期间的传染病.
背景情况:
- 细菌性阴道炎 (BV) 是孕妇常见的阴道疾病.
- BV与诸如自发早产 (spontaneous preterm birth,sPTB) 等不良怀孕结果之间的关联是孕产妇健康的一个重大问题.
- 了解持续或复发性BV的影响对于有效管理至关重要.
研究的目的:
- 调查怀孕期间持续性细菌性阴道炎 (BV) 与自发早产 (sPTB) 风险之间的联系.
- 为了比较治疗BV的女性与没有BV的女性的sPTB风险.
- 评估持续性BV,根据持续时间或治疗频率对sPTB率的影响.
主要方法:
- 一个大型商业保险数据库 (IBM MarketScan) 的回顾性分析.
- 包括12-55岁的单子妊娠妇女,与药物数据相关.
- 确定了BV诊断和治疗 (美特罗尼达/克林达米辛);持久性由多个月或处方来定义. 使用了几率比率和生存率分析.
主要成果:
- 分析了超过250万名妇女的队列,其中超过63,000名妇女接受了BV治疗.
- 与没有BV (5.7%) 相比,接受BV治疗的女性的sPTB频率更高 (7.5%).
- 在第一和第二个三个月 (1.66) 或在三次或更多处方 (1.48) 中接受 BV 治疗的妇女中,观察到最高的 sPTB 几率比率.
结论:
- 怀孕期间持续的细菌性阴道炎与自发早产的风险增加有关.
- 与单次发作相比,与更持久或频繁治疗的BV相比,sPTB的风险似乎更高.
- 很大一部分BV抗生素处方是在怀孕20周后发行的,这强调了及时诊断和管理的必要性.
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