First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women
First trimester bacterial vaginosis, individual microorganism levels, and risk of second trimester pregnancy loss among urban women
复制标题
DOI：
10.1016/j.fertnstert.2007.01.035
复制
发表时间：
2007-11-01
影响因子：
6.7
通讯作者：
Allen-Taylor, Lynne
中科院分区：
文献类型：
--
作者：
Nelson, Deborah B.;Bellamy, Scarlett;Allen-Taylor, Lynne
目的：探讨早期妊娠细菌性阴道病(BV)和BV相关微生物水平在城市妇女妊娠丢失风险中的作用。设计：前瞻性队列研究。地点：城市产前保健诊所。患者(S)：首次产前检查的妇女，已完成妊娠12周及以下且居住在宾夕法尼亚州费城。主要结局(S)：妊娠丢失。结果(S)：1948名妇女，平均胎龄10周(范围：7.4~12.6周)，与阴道菌群正常的妇女相比，BV相关阴道菌群改变程度最高的妇女在调整混杂因素后，中期妊娠丢失的风险增加了两倍以上(调整后的危险比[AHR]2.49，95%可信区间[CI]1.13至5.48)。低乳杆菌属。以及乳杆菌的缺失。与中期妊娠丢失的风险显著相关(AHR 1.32，95%CI 1.10~1.64；AHR 2.30，95%CI 1.09~4.85)。结论：BV总阳性与中期妊娠丢失无关。比较妊娠早期BV阳性的最高和最低三分位数，中期妊娠丢失和低剂量或缺乏乳杆菌的风险增加两倍。在怀孕的前三个月，也显着增加了中期妊娠丢失的风险。
Objective: To examine the role of first trimester bacterial vaginosis (BV) and level of BV-associated microorganisms, diagnosed using the Nugent gram stain criteria and the risk of second trimester pregnancy loss among urban women.Design: Prospective cohort study.Setting: Urban prenatal care clinics.Patient(s): Women presenting for their first prenatal care visit who had completed 12 weeks gestation or less and resided within Philadelphia, Pennsylvania.Main Outcome Measure(s): Pregnancy loss.Result(s): Of 1948 women enrolled at a mean gestational age of 10 weeks (range 7.4 to 12.6 weeks), those with the highest level of BV-related vaginal flora alteration compared with women with normal vaginal flora had over a twofold increased risk of second trimester pregnancy loss after adjustment for confounders (adjusted hazard ratio [aHR] 2.49, 95 % confidence interval [CI] 1.13 to 5.48). Low Lactobacillus spp. and the absence of Lactobacillus spp. were also significantly related to the risk of second trimester pregnancy loss (aHR 1.32, 95% CI 1.10-1.64; aHR 2.30, 95% CI 1.09-4.85; respectively).Conclusion(s): Overall BV positivity was not related to second trimester pregnancy loss. Comparing the highest to lowest tertile of BV positivity in early pregnancy conferred a two-fold increased risk of second trimester pregnancy loss and low amounts or the absence of Lactobacillus spp. in the first trimester also significantly increased the risk of second trimester pregnancy loss.