Analysis Of The Relationship Between Treatment Of Different Types Of Vaginal Inflammation During Pregnancy And Spontaneous Preterm Birth And Maternal And Infant Prognosis

Objective:To explore the relationship between the incidence and treatment of different types of vaginitis during pregnancy and spontaneous preterm birth(SPTB)and the prognosis of mother and infant.Methods:By consulting the electronic medical record system,a total of 900 pregnant women with spontaneous preterm delivery who underwent regular obstetric examination at Shengjing Hospital affiliated to China Medical University from January 2020 to April2022 and had vaginal secretion examination within 5 weeks before delivery were retrospectively collected as preterm delivery group,and were divided into treatment group and untreated group according to the type and treatment of vaginitis;Randomly select 900pregnant women who were in full term delivery in our hospital at the same time and underwent vaginal secretion examination within 5 weeks before delivery as the full-term control group.Collect their general data,pregnancy outcome,neonatal outcome,etc.through medical record system records and telephone follow-up,and analyze the relationship between the treatment of different types of vaginitis and spontaneous preterm delivery and adverse prognosis of mother and infant.Results:The cleanliness of vaginal discharge was abnormal in 159 cases(17.7%)in preterm group and 191 cases(21.2%)in term group.There were 75(8.3%)patients with bacterial vaginosis in the preterm group and 48(5.3%)in the term group.There were 76cases(8.4%)of group B streptococcus infection in the preterm group and 51 cases(5.7%)in the term group.There were 69 cases(7.7%)of vulvovaginal candidiasis in the preterm group and 39 cases(4.3%)in the term group.Multivariate logistic regression analysis was conducted,and the results showed that gestational age≥3(OR=1.425,95%CI:1.16-1.819),cervical dysfunction(OR=4.883,95%CI:3.200-7.452),BV(OR=1.539,95%CI:1.043-2.270),VVC(OR=1.872,95%CI:1.238-2.830),and GBS infection(OR=1.722,95%CI:1.183-2.505)were independent risk factors for premature birth,with statistical significance(P<0.05).There are a total of 123 BV patients,of which 48.0%of premature delivery patients follow medical advice for regular treatment,and 58.3%of full-term delivery patients receive treatment,with no statistically significant difference(χ~2=1.252,P=0.263)。There are a total of 108 VVC patients,of which 21.7%of premature delivery patients follow medical advice for regular treatment,and 33.3%of full-term delivery patients receive treatment,with no statistically significant difference(χ~2=1.744,P=0.187),there is no correlation between the occurrence of premature birth and the treatment of BV and VVC.Among premature delivery patients,there was no statistically significant difference in maternal and fetal prognosis between the BV treatment group and the untreated group;In the VVC group,the admission rate of newborns in the treatment group(46.7%)was lower than that in the untreated group(77.8%),and the difference was statistically significant(χ~2=5.520,P=0.019);The incidence of chorioamnionitis in GBS infection treated with intrapartum antibiotic prophylaxis(IAP)was significantly lower(26.8%)than that in the inadequate IAP group(51.4%),and the difference was statistically significant(χ~2=4.842,P=0.028),the incidence of neonatal sepsis in the sufficient IAP group(9.8%)was lower than that in the insufficient IAP group(28.6%),and the difference was statistically significant(χ~2=4.448,P=0.035)。Conclusions:The incidence of vaginitis in preterm delivery patients is significantly higher than that in full-term patients.The risk factors of spontaneous preterm delivery include≥3 pregnancies,cervical incompetence and genital tract infection(BV,VVC,GBS infection).However,routine screening of BV during pregnancy and regular treatment cannot reduce the incidence of preterm delivery and improve the prognosis of the mother and the baby.The treatment of VVC during pregnancy can reduce the admission of newborns and improve the prognosis of newborns to a certain extent.Routine screening of GBS and the application of antibiotics during delivery can reduce the incidence of chorioamnionitis and neonatal sepsis,to improve the prognosis of newborns.