既往有性病史孕妇更易发生死胎和早产

既往有性病史孕妇更易发生死胎和早产。发表于sexually transmitted infections杂志的一项最新研究表明,既往曾经有性传播疾病史的孕妇,如非淋淋病等,发生死胎和早产的风险比正常人要高。

既往研究已表明怀孕期间如果患有性病,那么容易发生孕期并发症,但是研究者声称,他们研究发现即使以往曾经患过性病的女性,怀孕期间即使好了,也比既往未有性病的孕妇更易发生死胎和早产。

研究人员在1999~2008年期间调查研究了354217名第一次怀孕女性。

最后研究发现既往有衣原体感染的女性所生低体重儿的概率比正常人要高。17%的可能发生意外是产,40%的可能发生死胎。

既往有淋病的女性意外早产率比正常人高2倍,但是低体重儿两者之间并无明显区别。由于既往患有淋病的女性数量较少,因此死胎率不好估计。

Abstract

Objectives To examine the association between prior chlamydia and gonorrhoea infections and adverse obstetric outcomes.

Methods Records of women resident in New South Wales, Australia with a singleton first birth during 1999–2008 were linked to chlamydia and gonorrhoea notifications using probabilistic linkage. Obstetric outcomes and potential confounders were ascertained from the birth record. Logistic regression, adjusted for potential confounders was used to estimate the association between a disease notification prior to the birth and adverse birth outcomes: spontaneous preterm birth (SPTB), small for gestational age (SGA) and stillbirth.

Results Among 354 217 women, 1.0% (n=3658) had a prior chlamydia notification; 0.06% (n=196) had a prior gonorrhoea notification. The majority of notifications (>80%) occurred before the estimated conception date. 4.1% of women had a SPTB, 12.1% had a SGA baby and 0.6% of women had a stillbirth. Among women with a prior chlamydia notification, the risk of SPTB and stillbirth was increased, aOR 1.17 (95% CI 1.01 to 1.37) and aOR 1.40 (95% CI 1.00 to 1.96) respectively but there was no association with SGA, aOR 0.99 (95% CI 0.89 to 1.09). For women with gonorrhoea the risks for SPTB, stillbirth and SGA were respectively aOR 2.50 (95%CI 1.39 to 4.50), 2.35 (95% CI 0.58 to 9.56) and 0.98 (95% CI 0.58 to 1.68). Among women with a prior chlamydia diagnosis, the risk of SPTB did not differ between women diagnosed >1 year prior to conception, within the year prior to conception or during the pregnancy, (p=0.9).

Conclusions Sexually transmissible infections in pregnancy and the preconception period may be important in predicting pregnancy outcomes.

参考文献: Bette Liu et al. Chlamydia and gonorrhoea infections and the risk of adverse obstetric outcomes: a retrospective cohort study. Sex Transm Infect doi:10.1136/sextrans-2013-051118

 

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