支原体感染与早产胎儿窘迫新生儿窒息的研究

流行病学研究发现,支原体感染可以通过垂直传播方式传给胎儿,越来越多的临床资料证实,孕妇解脲支原体、人型支原体、生殖支原体、发酵支原体被认为是致病或条件致病菌,妊娠期感染后可引起早产、胎儿窘迫、新生儿窒息。作者收集2005年1月~2005年12月在两个医院住院分娩的381例孕

Study on the relation of mycoplasma infection to premature labor, fetal distress and asphyxia neonatorum

Objective To study the relationship of mycoplasma infection of four kinds in perinatal puerperae to the risk of premature labor,fetal distress and asphyxia neonatorum,so that the undesirable pregnant outcomes may be avoided and the perinatal mortality reduced.Methods Cultures of ureaplasma urealyticum(Uu),mycoplasma hominis(Mh),mycoplasma genitalium(Mg) and mycoplasma fermentans(Mf) were made from vaginal secrection,amnionic fluid, umbilical blood and pharyngeal swab specimens collected from perinatal puerperae and neonates.381 puerperae were enrolled in the study,they were divided into mycoplasma positive and negative group according to the culture results.The rates of premature labor,fetal distress and asphyxia neonatorum in two groups were compared.Results Nested PCR revealed 117 puerperae to be mycoplasma positive and 264 puerperae to be mycoplasma negative.In mycoplasma positive group,there were 11(9.4%) premature labor,16(13.7%) fetal distress and 5(4.3%) asphyxia neonatorum.In mycoplasma negative group,the corresponding values were 5(1.8%),8(3.2%) and 2(0.74%) respectively;the differences between two groups were significant(P<0.05).Of 117 puerperae in whom mycoplasma tests were positive,mycoplasmas were also found in 48 of their infants,indicating a maternal-neonatal vertical transmission rate was 41%.Conclusion with two kinds of mycoplasmas or more was associated with a higher vertical transmission rate than those infected with only one kind of mycoplasma(70.6% vs 29.4%,P<0.05).Conclusion The mycoplasma infection rate in genital tract of perinatal puerperae was 30.7%.Mycoplasma infection is associated with a higher rate of premature labor,fetal distress and asphyxia neonatorum.In addition,vertical transmission rate was even higher in puerperae coinfected with two kinds of mycoplasmas or more than those infected with only one kind of mycoplasma.Early diagnosis and treatment may improve their prognosis.