孕产妇围生期感染危险因素及对妊娠结局的影响  

Risk factors for perinatal infection in puerpera and impact on pregnancy outcomes

作　　者：任海燕 李丹 马瑞玥 杨发萍 REN Hai-yan;LI Dan;MA Rui-yue;YANG Fa-ping(Linria Prefecture People's Hospital,Linria,Gansu 731100,China)

机构地区：[1]甘肃省临夏州人民医院产科,甘肃731100

出　　处：《中华医院感染学杂志》2023年第21期3288-3291,共4页Chinese Journal of Nosocomiology

基　　金：甘肃省自然科学基金资助项目(202178954)。

摘　　要：目的探究孕产妇围生期感染危险因素及对妊娠结局的影响.方法将2020年1月-2022年8月在甘肃省临夏州人民医院行孕期检查及分娩的202例孕产妇纳入研究,根据围生期感染情况分为围生期感染组41例、围生期未感染组161例,收集研究对象临床资料.通过单因素、多因素分析孕产妇围生期感染危险因素,并建立预测模型,采用受试者工作特征(ROC)曲线分析其预测价值,比较两组妊娠结局.结果202例在医院行孕期检查的孕产妇,41例发生围生期感染,发生率为20.30%.多因素Logistic分析结果显示,年龄、孕前体质量指数(BMI)、侵袭性操作、阴道清洁度为孕产妇围生期感染的危险因素(P<0.05).将上述因素纳入预测模型:logit(P)=-12.674+0.833×年龄≥35岁+孕前BMI≥24 kg/m^(2)×0.513+侵袭性操作×0.737+阴道清洁度Ⅲ~Ⅳ度×0.656,ROC曲线下面积(AUC)为0.941,诊断敏感度92.00%、特异度为90.00%.围生期感染组不良妊娠结局发生率高于围生期未感染组(P<0.05).结论多种因素与孕产妇围生期感染发生密切相关,构建预测模型对孕产妇围生期感染具有一定预测价值,且围生期感染发生不良妊娠结局危险更高,临床可据此制定相应预防措施.OBJECTIVE To explore the risk factors for perinatal infection and observe the impact on pregnancy outcomes of the puerpera.METHODS A total of 202 puerpera who received prenatal examinations and gave birth in Linxia Prefecture People's Hospital from Jan 2020 to Aug 2022 were enrolled in the study and were divided into the infection group with 4l cases and the no infection group with 16l cases according the status of perinatal infection.The clinical data were retrospectively collected from the research subjects.Univariate analysis and multivariate analysis were performed for the risk factors for the perinatal infection,the prediction model was established,the predictive value of the model was analyzed by receiver operating characteristic(ROC)curves,and the pregnancy outcomes of the two groups were observed.RESULTS Of the 202 puerpera who received the prenatal examinations,41 had perinatal infection,with the incidence rate 20.30%.The result of multivariate logistic analysis showed that age,progestational body mass index(BMI),invasive operation and vaginal cleanliness were the risk factors for the perinatal infection(P<0.05).The above factors were included in the prediction model:logit(P)=-12.674+0.833×no less than 35 years of age+progestational BMI no less than 24 kg/m^(2)×0.513+invasive operationX0.737+vaginal cleanliness betweenⅢandⅣ×0.656.The area under ROC curve(AUC)was 0.941,with the sensitivity 92.00%,the specificity 90.00%.The incidence of adverse pregnancy outcomes was significantly higher in the infection group than in the no infection group(P<0.05).CONCLUSION The incidence of perinatal infection of the puerpera is closely associated with a variety of factors,the prediction model has certain value in prediction of the perinatal infection,the puerpera with perinatal infection are at higher risk of adverse pregnancy outcomes,and it is necessary for the hospital to develop the corresponding prevention measures.

关 键 词：围生期感染 孕产妇 危险因素 预测模型 妊娠结局 

分 类 号：R714.7[医药卫生—妇产科学]