宫-阴道微生物群和子宫长度的交集在预测早产期的不良周产期结果时,会增加早产风险
Gulcan Okutucu1, Atakan Tanacan2, Nazli Bayraktar3
1Department of Obstetrics and Gynecology, Division of Perinatology, Ministry of Health Ankara Bilkent City Hospital, 1604th Street, No: 9, Cankaya/Ankara, 06800, Turkey. gulcanokutucu@gmail.com.
BMC pregnancy and childbirth
|October 3, 2025
概括
孕妇的细菌宫性阴道菌群 (CVF) 增加了早产和不良围产结局的风险. 与CVF一起监测宫长度 (CxL) 可以帮助预测这些结果.
科学领域:
- 产科和妇科 产科和妇科
- 微生物学 微生物学
- 围产儿医学 围产儿医学
背景情况:
- 宫阴道 (CV) 微生物群在怀孕结果中起着至关重要的作用.
- 某些条件增加了早产风险,需要对CV环境进行评估.
- 了解心血管微生物群与周产期不良结果之间的联系对于临床管理至关重要.
研究的目的:
- 分析高风险早产的孕妇的宫阴道 (CV) 微生物群组成.
- 确定CV培养中的致病微生物与复合不良周产期结局 (CAPO) 之间的关联.
主要方法:
- 包括665名怀孕妇女的心脏血管培养结果,这些孕妇因威胁早产 (TPL),早产早产膜破裂 (PPROM) 或子宫缺陷 (CIS) 住院.
- 分类CV培养成正常的 (Lactobacillus spp. 主导性),候选性和细菌性宫性阴道菌群 (CVF).
- 定义CAPO为围产死亡率或至少两个新生儿并发症 (如败血症,呼吸困扰).
主要成果:
- 在35.2%的参与者中发现了非正常的CVF.
- 细菌性CVF与更高的早产率 (p=0.024) 和CAPO (52.5%,p=0.021) 和较低的出生体重 (p=0.011) 有关.
- 宫长度 (CxL) 的切线为28.5毫米,在非正常的CVF存在时有效预测CAPO (AUC:0.763,p<0.001).
结论:
- 在CVF中细菌占主导地位是高风险怀孕中不良围产期结局的重要风险因素.
- 将CxL监测与CVF评估相结合,可以改善对围产期不良结果的预测.
- 这些发现支持加强产科管理和及时干预高危孕妇.
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