孕晚期妇女阴道微生态流行病学调查分析

目的 探讨孕晚期妇女阴道微生态状况，为进一步施行干预措施提供实验依据。方法 采用病例对照研究，采集研究对象下阴道2/3的白带样本进行阴道微生态检测，判定研究对象的阴道微生态状况。结果 共纳入4 852名孕晚期妇女及2 500名正常体检妇女进行阴道微生态的基本情况分析，孕晚期妇女的阴道微生态失衡状况高于非孕妇女。影响孕晚期妇女的阴道微生态失衡因素为H2O2阴性（OR=0.84，P=0.012）、唾液酸苷酶阳性（OR=2.25，P<0.001）、乳杆菌比例少（OR=2.73，P<0.001）、AV评分较高（OR=1.12，P=0.039）、酵母样真菌感染/定植（OR=2.22，P<0.001）、酵母样真菌与加德纳/普雷沃菌混合感染（OR=1.82，P=0.032）、Nugent评分较高（OR=1.41，P<0.001）及阴道Ⅲ~Ⅳ级的清洁度人数较多（OR=1.28，P=0.028）。结论 本地区孕晚期妇女阴道微生态存在失衡状况，下一步需提出合理干预措施，减少妊娠不良结局的风险。

Epidemiological observation on vaginal microecology in women in late pregnancy

Objective To observe the vaginal microecological condition of women in late pregnancy，and provide evidences for further intervention．Methods Specimens of vaginal secretion were collected for vaginal microbiological detection and microecological analysis．Results A total of 4，852 women in late pregnancy and 2，500 healthy non-pregnant women were enrolled．The rate of imbalance of vaginal microecology in late pregnancy group was higher than in controls．The factors that affected the vaginal microecological balance of women in late pregnancy were negative for H2O2（OR=0.84，P=0.012），positive for sialidase（OR=2.25，P<0.001），less percentage of Lactobacillus spp．（OR=2.73，P<0.001），higher score of AV（OR=1.12，P=0.039），yeast-like fungal infection/colonization（OR=2.22，P<0.001），mixed infection of fungi and Gardner（OR=1.82，P=0.032），higher Nugent score（OR=1.41，P<0.001）and higher rate of vaginal cleanliness of Ⅲ-Ⅳ（OR=1.28，P=0.028）．Conclusion Imbalance of vaginal microecology exists in women in late pregnancy in the local region．Reasonable intervention measures should be proposed to reduce the risk of adverse pregnancy outcomes．