足月妊娠隐匿性绒毛膜羊膜炎相关因素分析

目的 探讨孕产期各种因素对足月妊娠发生隐匿性绒毛膜羊膜炎的影响.方法 回顾性分析796例自2006年12月至2008年12月在中国人民解放军第三○六医院足月妊娠分娩产妇中隐匿性绒毛膜羊膜炎(SCCAS)的发生情况.采用χ~2检验,分析产妇的年龄、孕产次、孕周、产检情况、阴道炎病史、胎膜早破、职业、户口所在地、受教育程度、分娩方式等因素与隐匿性绒毛膜羊膜炎的关系.结果 足月分娩产妇中SCCAS发生率为39.95%.其中未规范产检者SCCAS发生率高于规范产检者(P<0.01,OR0.6,95%CI 0.8-0.4);无职业者的SCCAS发生率高于有职业者(P<0.01,OR 0.6,95%CI 0.8-0.5);有阴道炎病史的SCCAS发生率高于无阴道炎者(P<0.01,OR 2.8,95%CI 1.9～4.0);胎膜早破SCCAS发生率高于无胎膜早破者(P<0.05,OR 1.5,95%C/1.0～2.2).而产妇的年龄、孕产次、孕周、户口、受教育程度、分娩方式等其他7项因素与SCCAS发生率差异无统计学意义.结论 足月妊娠的产妇,即使无感染的症状体征,仍可能已经发生了绒毛膜羊膜炎,其发生率与卫生习惯、有否规范产检、阴道炎病史和胎膜早破有关.

Study of factors associated with subclinical chorioamnionitis in term pregnancy

Objective To investigate the effects of various factors upon subclinical chorioamnionitis (SCCAS) during pregnancy and delivery. Methods A total of 796 cases of pregnancy in full-term birth at our hospital from December 2006 to December 2008 were reviewed. The data of maternal age, gravidity,parity, gestational age, prenatal care, history of vaginitis, premature rupture of membranes, occupation,educational status and delivery mode were recorded. And then the relationship between one of them and chorioamniotis were analyzed by χ~2 test. Results The overall incidence of SCCAS was 39. 95% in full-term birth. The pregnant women, who had no prenatal care or no occupation, or had a history of vaginitis or premature rupture of membranes, were found to have a higher incidence (P <0. 05 or P <0. 01 ). However,there were no statistical significance ( P > 0. 05 ) between SCCAS and other seven factors, such as gravida age, gravidity, parity, gestational age, educational status, delivery mode and living conditions. Conclusion Women with full-term birth, even in the absence of symptoms, may have already suffered from acute or chronic chorioamnioitis. The incidence is associated with prenatal care, history of vaginifis and premature rupture of membranes.