妊娠期女性牙龈卟啉单胞菌感染对不良妊娠结局的影响  

Influence of P. gingivalis infection during pregnancy on adverse pregnancy outcomes

作　　者：龙黎南 储莉鸣[1] 丁晓颖[2] 张治萍[1] 胡逸凡 王珣 谢震宇 LONG Linan;CHU Liming;DING Xiaoying;ZHANG Zhiping;HU Yifan;WANG Xun;XIE Zhenyu(Department of obstetrics and gynecology,Shanghai Pudong Health care hospital for Women&hildren,Shanghai 201206,China;Medical education department,Shanghai Pudong Health care hospital for Women&hildren,Shanghai 201206,China;Hospital office,Shanghai Pudong Health care hospital for Women&hildren,Shanghai 201206,China)

机构地区：[1]上海市浦东新区妇幼保健院妇产科,上海201206 [2]上海市浦东新区妇幼保健院医教科,上海201206 [3]上海市浦东新区妇幼保健院院办,上海201206

出　　处：《中国妇幼健康研究》2023年第7期59-66,共8页Chinese Journal of Woman and Child Health Research

基　　金：上海市浦东新区科技发展基金(PKJ2021-Y62);上海市浦东新区卫生系统医学学科建设资助(PWYts2021-19)。

摘　　要：目的 探讨妊娠期女性牙龈卟啉单胞菌(P.gingivalis)感染的高危因素及对不良妊娠结局的影响。方法 选取2021年12月至2022年2月在上海市浦东新区妇幼保健院初诊的孕早期孕妇为研究对象,采用实时PCR对孕妇的唾液进行P.gingivalis检测,多因素Logistic回归分析妊娠期P.gingivalis感染的影响因素;根据P.gingivalis感染状况将研究对象分为感染组和对照组,比较两组的不良妊娠结局。结果 共390例孕妇纳入研究,孕期P.gingivalis感染率为45.13%。多因素Logistic回归分析显示,高龄(年龄35~<40岁:OR=1.674,95%CI:1.058~2.648;≥40岁:OR=2.085,95%CI:1.026~4.238)、吸烟(OR=2.916,95%CI:1.051~8.094)、高中及以下文化程度(OR=2.017,95%CI:1.310~3.105)、不良孕产史(OR=1.788,95%CI:1.017~3.144)、患有阴道炎(OR=1.877,95%CI:1.217~2.896)是妊娠期女性P.gingivalis感染的独立危险因素(P<0.05)。感染组B族链球菌(GBS)阳性、子痫前期、妊娠期糖尿病(GDM)、早产、胎儿生长受限(FGR)的发生率明显高于对照组(χ^(2)/t值分别为4.012、5.894、5.009、4.543、4.031,P<0.05);在控制了混杂因素后,多因素分析显示P.gingivalis感染明显增加了不良妊娠结局的发生风险(OR=2.175,95%CI:1.291~3.662),P.gingivalis感染的孕妇不良妊娠结局的发生率是未感染孕妇的1.778倍(RR=1.778,95%CI:1.223~2.432)。结论 妊娠期女性牙龈P.gingivalis感染率高,是不良妊娠结局发生的危险因素,应关注妊娠期女性牙龈P.gingivalis的感染状况,尤其加强高危人群的口腔健康教育。Objective To investigate the high-risk factors of Porphyromonas gingivalis(P.gingivalis)infection and its influence on adverse pregnancy outcomes.Methods The pregnant women in the first trimester who conducted the first prenatal examination in Shanghai Pudong New Area Health Care Hospital for Women&Children from December 2021 to February 2022 were selected as the study subjects.Real time PCR was used to detect P.gingivalis in the saliva of pregnant women.Multivariate Logistic regression was used to analyze the influencing factors of P.gingivalis infection during pregnancy.According to the P.gingivalis infection status,study subjects were divided into the infection group and the control group,and adverse pregnancy outcomes of the two groups were compared.Results A total of 390 pregnant women were included in this study.The infection rate of P.gingivalis was 45.13%.Multivariate Logistic regression analysis showed that advanced age(age of 35-<40 years old:OR=1.674,95%CI:1.058-2.648;≥40 years old:OR=2.085,95%CI:1.026-4.238),smoking(OR=2.916,95%CI:1.051-8.094),educational level of high school or below(OR=2.017,95%CI:1.310-3.105),history of adverse pregnancy outcomes(OR=1.788,95%CI:1.017-3.144)and vaginitis(OR=1.877,95%CI:1.217-2.896)were the independent risk factors of P.gingiualis infection during pregnancy(P<0.05).The incidences of group B Streptococcus(GBS)positive,preeclampsia,gestational diabetes mellitus(GDM),preterm birth and fetal growth restriction(FGR)in the infection group were significantly higher than those in the control group(χ^(2)/t=4.012,5.894,5.009,4.543 and 4.031,respectively,P<0.05).After controlling for confounding factors,multivariate analysis showed that P.gingivalis infection significantly increased the risk of adverse pregnancy outcomes(OR=2.175,95%CI:1.291-3.662).The incidence of adverse pregnancy outcomes in pregnant women with P.gingivalis was 1.778 times higher than that in the control group(RR=1.778,95%CI:1.223-2.432).Conclusion P.gingivalis infection rate during pregnancy is high and

关 键 词：妊娠期 牙龈卟啉单胞菌 妊娠结局 前瞻性队列研究 影响因素 

分 类 号：R173[医药卫生—妇幼卫生保健]