孕妇TORCH感染影响因素分析及对妊娠结局的影响
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摘要
目的探究孕妇TORCH感染情况、影响因素及对妊娠结局的影响。方法选取2015年3月至2017年8月在杭州市第一人民医院接受产检的1 000例孕妇,对其进行TORCH检验,同时采用问卷调查的方式收集影响TORCH感染发生的因素,计数资料及单因素分析采用χ~2检验,采用Logistic回归方法进行多因素分析,对比TORCH感染组与无感染组孕妇不良妊娠结局。结果 1 000例孕妇中检出79例TORCH感染者,将其作为感染组,总感染率7.90%,其中风疹病毒(RV)感染15例(1.50%)、弓形虫(TOX)感染5例(0.50%)、巨细胞病毒(CMV)感染35例(3.50%)、单纯疱疹病毒I型(HSV)感染11例(1.10%)、单纯疱疹病毒Ⅱ型(HSVⅡ)感染13例(1.30%);在上述几项病毒感染中以CMV感染居多。对1 000例孕妇女进行TORCH相关因素分析发现,TORCH感染与孕妇的年龄、受教育程度、家庭背景、动物接触史、妊娠异常史、收入水平有明显的相关性(χ~2值分别为8.07、12.53、5.88、19.11、112.70、7.56,均P<0.05)。进行多因素Logistics回归方程分析显示,年龄、家庭背景、动物接触史、妊娠异常史是孕妇TORCH发生的高危因素(Waldχ~2值分别为8.77、7.82、9.81、19.36,均P<0.05),受教育程度是保护因素(Waldχ~2=29.12,P<0.05)。在不良妊娠结局方面,感染组宫内感染、早产、流产、胎儿发育迟缓及新生儿死亡的发生率显著高于无感染组(χ~2值分别为46.51、20.47、14.93、38.54、24.85,均P<0.05)。结论年龄、受教育程度、家庭背景、动物接触史、妊娠异常史是影响孕妇感染TORCH的重要因素,此外TORCH感染与不良妊娠的发生密切相关,是不良妊娠结局的危险因素。
Objective To investigate the TORCH infection in pregnant women,its influencing factors and the impact on pregnancy outcomes.Methods Totally 1 000 pregnant women for TORCH test were selected in Hangzhou First People's Hospital from March2015 to August 2017.At the same time,aquestionnaire was used to collect the factors influencing TORCH infection,andχ~2 test was used for counting data and univariate analysis.Multivariate logistic regression analysis was used to compare the adverse pregnancy outcomes in TORCH infection group and non-infection women.Results Among 1 000 pregnant women selected for TORCH-IgM antibody detection,79 cases were detected with TORCH infection and they were in infection group.The total infection rate was 7.90%.There were 15 cases of RV infection(1.50%),5 cases of TOX infection(0.50%),35 cases of CMV infection(3.50%),11 cases of HSV Ⅰ infection(1.10%)and 13 cases of HSV Ⅱ infection(1.30%).Among the above viral infections,most of them were infected with CMV.TORCH related factors analysis of 1 000 pregnant women found that TORCH infection was correlated with age,education level,family background,animal exposure history,abnormal pregnancy history and income level of pregnant women(χ~2 value was 8.07,12.53,5.88,19.11,112.70 and 7.56,respectively,all P<0.05).Logistic regression analysis of multiple factors showed that age,educational level,family background,animal exposure history and abnormal pregnancy history were the high-risk factors of TORCH in pregnant women(χ~2 value was 8.77,7.82,9.81 and 19.36,respectively,all P<0.05),and that the level of education was a protective factor(χ~2=29.12,P<0.05).In adverse pregnancy outcomes,the incidence of intrauterine infection,premature birth,abortion,fetal retardation and neonatal death was significantly higher in infection group than in non-infection group(χ~2 value was 46.51,20.47,14.93,38.54 and 24.85,respectively,all P<0.05).Conclusion Age,education level,family background,animal exposure history and history of abnormal pregnancy are important factors affecting TORCH infection in pregnant women.In addition,TORCH infection is closely related to the occurrence of adverse pregnancy,which is a risk factor for adverse pregnancy outcomes.
Objective To investigate the TORCH infection in pregnant women,its influencing factors and the impact on pregnancy outcomes.Methods Totally 1 000 pregnant women for TORCH test were selected in Hangzhou First People's Hospital from March2015 to August 2017.At the same time,aquestionnaire was used to collect the factors influencing TORCH infection,andχ~2 test was used for counting data and univariate analysis.Multivariate logistic regression analysis was used to compare the adverse pregnancy outcomes in TORCH infection group and non-infection women.Results Among 1 000 pregnant women selected for TORCH-IgM antibody detection,79 cases were detected with TORCH infection and they were in infection group.The total infection rate was 7.90%.There were 15 cases of RV infection(1.50%),5 cases of TOX infection(0.50%),35 cases of CMV infection(3.50%),11 cases of HSV Ⅰ infection(1.10%)and 13 cases of HSV Ⅱ infection(1.30%).Among the above viral infections,most of them were infected with CMV.TORCH related factors analysis of 1 000 pregnant women found that TORCH infection was correlated with age,education level,family background,animal exposure history,abnormal pregnancy history and income level of pregnant women(χ~2 value was 8.07,12.53,5.88,19.11,112.70 and 7.56,respectively,all P<0.05).Logistic regression analysis of multiple factors showed that age,educational level,family background,animal exposure history and abnormal pregnancy history were the high-risk factors of TORCH in pregnant women(χ~2 value was 8.77,7.82,9.81 and 19.36,respectively,all P<0.05),and that the level of education was a protective factor(χ~2=29.12,P<0.05).In adverse pregnancy outcomes,the incidence of intrauterine infection,premature birth,abortion,fetal retardation and neonatal death was significantly higher in infection group than in non-infection group(χ~2 value was 46.51,20.47,14.93,38.54 and 24.85,respectively,all P<0.05).Conclusion Age,education level,family background,animal exposure history and history of abnormal pregnancy are important factors affecting TORCH infection in pregnant women.In addition,TORCH infection is closely related to the occurrence of adverse pregnancy,which is a risk factor for adverse pregnancy outcomes.
引文
[1]李媛媛,张海鲲,李忠良,等.不良妊娠结局现状及其影响因素分析[J].中国妇幼健康研究,2014,25(4):577-580.
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[6]米东,祁珮,陈淑琴,等.天津地区不孕妇女和孕妇TORCH感染的检测分析[J].国际检验医学杂志,2014,35(2):241-243.
[7]张媛媛,刘蓓蓓,张迎梅.淮安地区孕妇TORCH感染血清抗体筛查结果分析[J].东南大学学报(医学版),2017,36(1):78-81.
[8]谭雪莲,倪永圣,陈展泽,等.1205例孕妇血清单纯疱疹病毒感染调查与分析[J].国际检验医学杂志,2014,35(7):846-847.
[9]Prasoona K R,Srinadh B,Sunitha T,et al.Seroprevalence and influence of Torch infections in high risk pregnant women:a large study from South India[J].J Obstet Gynaecol India,2015,65(5):301-309.
[10]Kaur K,Oberoi A.Prevalence of various Torch infections among females of reproductive age group[J].J Evol Med Dent Sci,2015,4(65):11391-11396.
[11]Dolgushin S A,Odintsova E S,Gerasimenko A Y,et al.Preliminary tests of multiplex immunoassay for detection of TORCH infections in human blood serum using flow cytometry[J].Biomed Eng,2015,49(2):85-89.
[2]章锦曼,阮强,张宁,等.TORCH感染筛查、诊断与干预原则和工作流程专家共识[J].中国实用妇科与产科杂志,2016,32(6):535-540.
[3]Neu N,Duchon J,Zachariah P.TORCH infections[J].Clin Perinatol,2015,42(1):77-103.
[4]Merzlova N B,Serova I A,Yagodina A Y.Relevant principles in the diagnosis,treatment,and prevention of toxoplasmosis during pregnancy[J].Med Parazitol(Mosk),2015,(3):13-17.
[5]牛艳红,于周涛,冀会萍.TORCH感染与不良妊娠结局的关系研究[J].中华医院感染学杂志,2014,24(16):4103-4104,4107.
[6]米东,祁珮,陈淑琴,等.天津地区不孕妇女和孕妇TORCH感染的检测分析[J].国际检验医学杂志,2014,35(2):241-243.
[7]张媛媛,刘蓓蓓,张迎梅.淮安地区孕妇TORCH感染血清抗体筛查结果分析[J].东南大学学报(医学版),2017,36(1):78-81.
[8]谭雪莲,倪永圣,陈展泽,等.1205例孕妇血清单纯疱疹病毒感染调查与分析[J].国际检验医学杂志,2014,35(7):846-847.
[9]Prasoona K R,Srinadh B,Sunitha T,et al.Seroprevalence and influence of Torch infections in high risk pregnant women:a large study from South India[J].J Obstet Gynaecol India,2015,65(5):301-309.
[10]Kaur K,Oberoi A.Prevalence of various Torch infections among females of reproductive age group[J].J Evol Med Dent Sci,2015,4(65):11391-11396.
[11]Dolgushin S A,Odintsova E S,Gerasimenko A Y,et al.Preliminary tests of multiplex immunoassay for detection of TORCH infections in human blood serum using flow cytometry[J].Biomed Eng,2015,49(2):85-89.