孕妇阴道微生态失衡与炎症因子水平预测妊娠结局的临床研究OA

Objective To explore the impact of tracking the imbalance of vaginal microbiota in pregnant women and the level of inflammatory factors on predicting pregnancy outcomes.Method A prospective cohort study was conducted to analyze the clinical data of 400 late pregnancy women who underwent prenatal examinations in the obstetrics and gynecology department of Hengshui Maternal and Child Health Hospital from December 2022 to December 2023.Collect vaginal secretions from parturients and undergo vaginal microbiota testing.Use enzyme-linked immunosorbent assay to detect hs CRP,PCT,and IL-6 levels.Track the results of vaginal microbiota testing and pregnancy outcomes of pregnant women,and divide them into an observation group(imbalanced microbiota,n=200)and a control group(normal microbiota,n=200)based on the results of vaginal microbiota t esting.According to pregnancy outcomes,they were divided into a good group(n=316)and an adverse group(n=84).Compare baseline data and adverse pregnancy outcomes between the vaginal microbiota imbalance group and the normal group.Compare the clinical characteristics of the group with good pregnancy outcomes and the group with poor pregnancy outcomes.Using logistic regression to analyze the influencing factors of adverse pregnancy outcomes.The predictive efficacy of ROC analysis on vaginal microbiota and inflammatory factor levels for adverse pregnancy outcomes.Results The levels of hs CRP,PCT,IL-6,adverse pregnancy outcomes(premature rupture of membranes,premature birth,chorioamnionitis,neonatal infection),and overall incidence rate in the group with vaginal microbiota imbalance were higher than those in the normal group(P<0.05).The proportion of hs CRP,PCT,IL-6 levels,vaginal microbiota density Ⅰ,Ⅳ,diversity Ⅰ,Ⅳ,dominant bacteria being non Gram positive bacteria,Candida positive,and vaginal pH≥4.5 in the group with poor pregnancy outcomes were higher than those in the normal group(P<0.05).Logistic regression analysis showed that hs CRP,PCT,IL-6 levels,vaginal microbiota density and diversity levels Ⅰ and Ⅳ,dominant bacteria being non Gram positive bacilli,Candida positive,and vaginal pH≥4.5 were all risk factors for adverse pregnancy outcomes(OR>1,P<0.05).The ROC curve results show that the predictive value AUC(95％CI)is 0.914(0.856～0.937).Conclusion Vaginal microecological imbalance and inflammatory factor construction have high value in predicting adverse pregnancy outcomes.