在怀孕期间是否查无症状细菌性尿症:两家产妇中心之间的比较性三年后期审查
Elaine Houlihan1, Rachel Barry2, Susan J Knowles3
1Dr Elaine Houlihan and Dr Rachel Barry are joint first authors and contributed equally to this work; Department of Microbiology, National Maternity Hospital, Dublin, Ireland.
概括
在孕妇中对无症状细菌性尿症 (AB) 的查与肌炎或早产率的增加无关. 忽略常规的AB查可能是一个具有成本效益的策略,而不会影响护理质量.
科学领域:
- 产科和妇科 产科和妇科
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 目前的爱尔兰国家指导建议在怀孕期间 (12-16周怀孕) 查无症状细菌性尿症 (AB),并使用抗微生物药物治疗.
- 该建议基于有限的证据,表明AB与不良妊娠结果 (如早产和低出生体重婴儿 (LBWI)) 之间的联系.
研究的目的:
- 为了比较产前炎症,早产和LBWI的发病率,在有或没有例行无症状细菌尿症查的产科医院之间.
- 评估遗漏AB查对关键产科结果的影响.
主要方法:
- 在两家爱尔兰分娩医院进行了为期三年的 (2018-2020) 产后评估.
- 一家医院 (罗通达医院 - RH) 对AB进行了查,而另一家 (国家产科医院 - NMH) 没有.
- 鉴定了需要静脉注射抗生素的炎症患者,并将查和未查人群之间的结果与医院之间的结果进行了比较.
主要成果:
- 在这两家医院之间,在产前炎症率 (p=0.34) 或早产率 (p=0.21) 中没有发现统计学上显著的差异.
- 具有查 (RH) 的医院与非查医院 (NMH) (5.68%) (p<0.004) 相比,LBWI (6.45%) 的比率显著更高 (p<0.004).
- 在查医院内的子组分析显示,查和未查患者之间,或与非查医院相比,肌炎率没有显著差异.
结论:
- 忽略例行无症状细菌尿查并没有导致产前炎症,早产或LBWI的发病率增加.
- 这些发现表明,在高风险怀孕中选择性查AB可能是一个更具成本效益的方法,同时保持护理质量.
- 这项研究可能会为未来关于无症状细菌尿症产前查方案的国家指导方针提供信息.
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