胎儿畸形与孕妇生殖道解脲脲原体感染的相关性

背景解脲脲原体引起女性泌尿生殖道感染可导致不育不孕和自然流产,但其是否为导致胎儿畸形的因素之一尚不十分清楚.目的探讨解脲脲原体感染是导致胎儿畸形重要因素之一.设计以患儿及其父母为研究对象,非随机化同期对照,观察对比研究.单位一所医学院的微生物与免疫学教研室.对象选择1995/1997由泸州医学院微免教研室对泸州医学院第一附属医院妇产科和泸州市第一人民医院妇产科门诊及住院16例畸形胎儿(女3例,男13例)及其父母为研究对象.方法对16例畸形胎儿脐带血,畸形儿父亲的精液和异常妊娠产妇的宫颈黏液或阴道分泌物进行解脲脲原体分离.采用大环内酯类和氨基糖甙类抗生素对11例夫妇进行治疗,然后追踪再次妊娠及生育现象.主要观察指标脲脲原体感染与胎儿畸形的关系.结果16例中11例解脲脲原体阳性,阳性率为69%.11例解脲脲原体阳性者抗风疹病毒、抗巨细胞病毒、抗弓形抗体和染色体均未发现异常.已追踪到的4例再次妊娠结果、妊娠过程正常,新生儿发育良好,追踪观察到2岁未发现器质性和功能性异常.结论女性生殖道解脲脲原体感染与胎儿畸形的发生有一定关系,从而为干预胎儿畸形发生提供理论依据.

Correlation between genital tract Ureaplasma urealyticum infection in pregnant women and fetal malformation

BACKGROUND: Ureaplasma urealyticum may cause female genital tracts infection and lead sterility, infertility and spontaneous abortion. But it still is not clear whether Ureaplasma urealyticum is one of the factors responsible for fetal malformation.OBJECTIVE: To investigate whether Ureaplasma urealyticum is one of the key factor responsible for fetal malformation.DESIGN: Non-randomized observation of compromised children and their parents with concurrent control.SETTING: The department of immunology and microbiology of a medical college.PARTICIPANTS: Totally 16 malformed fetuses(3 female and 13 male cases) and their parents were chosen from the family seeking pregnancy care in the Department of Gynecology and Obstetrics of the First Affiliated Hospital of Luzhou Medical College and Luzhou First People's Hospital from 1995 to 1997.METHODS: Ureaplasma urealyticum detection was performed in 16 samples of the umbilic blood of the malformed fetuses, sperms of the father, and cervical mucus of the mother who conceived the malformed fetus. The 11 couples positive for Ureaplasma urealyticum were treated with macrolides and aminoglycoside antibiotics and followed up for the outcome of the following pregnancy.MAIN OUTCOME MEASURES: The relation between Ureaplasma urealyticum infection and fetal malformation was examined.RESULTS: Totally 11 of the 16 umbilical blood samples(69% ) were positive for Ureaplasma urealyticum, and serological tests of parents in the 11 positive cases detected rubella virus, cytomegalovirus or Toxoplasma gondii antibodies, nor was abnormality found in chromosomal examination. The following pregnancies and delivery were followed up in 4 women, and the babies showed no functional or organic abnormities with good development till the age of 2 years.CONCLUSION: Female genital tract Ureaplasma urealyticum infection is related to fetal malformation, which provides evidence to support interventions of the occurrence of fetal malformation.