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目的 探索孕妇生殖道支原体寄居与异常围生结局的病因学关系。方法 选择进行围生期保健孕妇739例,根据支原体检测结果将其分成支原体阳性孕妇队列和支原体阴性孕妇队列,随访至围生期结束,比较2组异常围生结局发生率。结果 支原体阳性孕妇队列中早产、产后热、产褥感染及胎儿宫内窘迫的发生率高于支原体阴性孕妇队列(P<0.05)。分析不同支原体寄居与异常围生结局关系,发现解脲脲原体主要引起早产(RR=3.28,95％CI为1.75～6.14)和胎儿宫内窘迫(RR=3.61,95％CI为1.56～8.33)发生率增加;人型支原体主要导致新生儿肺炎(RR=5.16,95％CI为1.99～13.38)、产后热(RR=5.91,95％CI为2.01～17.42)和产褥感染(RR=4.14,95％CI为1.79～9.6)等异常围生结局发生率的增加。支原体混合寄居表现出协同效应。结论 围生期孕妇生殖道支原体寄居能引起异常围生结局发生率的增加,应大力加强对孕妇支原体寄居的防治工作。
Objective To explore the etiology of mycoplasma inhabitation and abnormal perinatal outcome in pregnant women. Methods 739 pregnant women of perinatal health care were selected. According to their mycoplasma test results, they were divided into mycoplasma-positive pregnant women cohort and mycoplasma negative pregnant women cohort. The patients were followed up to the end of perinatal period. The incidence of abnormal perinatal outcome was compared between the two groups. Results The prevalence of prematurity, postpartum fever, puerperal infection and fetal distress in the mycoplasma positive pregnant women cohort was higher than that of the negative mycoplasma negative pregnant women cohort (P <0.05). The relationship between the different Mycoplasma spp and the abnormal perinatal outcome was analyzed. It was found that Ureaplasma urealyticum mainly caused premature delivery (RR = 3.28, 95% CI 1.75-1.44) and fetal distress (RR 3.61, 95% CI 1.56-8.33 (RR = 5.16, 95% CI: 1.99 ~ 13.38), postpartum fever (RR = 5.91, 95% CI 2.01-17.42) and puerperal infection (RR = 4.14 , 95% CI 1.79 ~ 9.6) and other abnormal perinatal outcomes increased. Mycoplasma hybrid lodging show synergistic effect. Conclusions Perinatal gynecological mycoplasma inhabiting in pregnant women can cause an increase in the incidence of abnormal perinatal outcome. Therefore, prevention and treatment of Mycoplasma hyopneumoniae in pregnant women should be greatly strengthened.