Research on the relationship between premature delivery and preterm premature rupture of membranes and reproductive tract infection during pregnancy

Wang Chunjing; Meng Wenying; Zhai Jianjun

doi:10.3760/j.issn.1673-4777.2024.07.020

Abstract：Objective To clarify the correlation between premature delivery and preterm premature rupture of membranes(PPROM)and reproductive tract infection(RTI)during pregnancy.Methods A total of 416 pregnant women with preterm or PPROM who received regular prenatal examination and delivered in Tongzhou Maternal &Child Health Hospital of Beijing from January 2021 to December 2022 were selected as the research objects.According to whether there was clear evidence of RTI pathogen during delivery(admission during delivery),the patients were divided into observation group(171 cases,with evidence)and control group(245 cases,without evidence).The relevant data of pregnant women were analyzed,and the incidence of vaginitis,PPROM,gestational age,delivery method,incidence of fetal intrauterine distress,pregnancy outcomes of pregnant women of different ages,and birth weight of newborns at the same gestational age were compared between two groups.Results Among 171 pregnant women in the observation group,the top 3 pathogens in routine vaginal secretions examination were 14 cases(8.2％)of Mycoplasma urealyticum infection,13 cases(7.6％)of bacterial vaginosis,and 10 cases(5.8％)of fungal vaginitis.The common pathogens of RTI cultured in bacteriology were Streptococcus agalactiae in 9 cases(5.3％),Candida albicans in 8 cases(4.7％),and Escherichia coli in 6 cases(3.5％).The proportion of vaginal inflammation in the observation group during early pregnancy was higher than that in the control group[18.7％(32/171)vs 11.4％(28/245)](P=0.042).There were statistically significant differences between the observation group and the control group in terms of PPROM incidence,gestational age,delivery method,and incidence of fetal intrauterine distress(all P＜0.05).There was no statistically significant difference in incidence of PPROM,RTI and fetal distress among pregnant women of different age groups(all P＞0.05).There was no statistically significant difference in the birth weight of newborns born at the same gestational age between the observation group and the control group(all P＞0.05).Conclusions Mycoplasma urealyticum,Streptococcus agalactis and Candida albicans are the main pathogenic bacteria of reproductive tract infection.Gestational RTI may increase the risk of premature delivery and PPROM,and gestational RTI may increase the adverse outcome of mother and child during pregnancy.