妊娠期生殖道感染及其与早产的关系

T. Susilawati, Yohanes Aditya Adhi Satria
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引用次数: 0

摘要

生殖道感染(GTI)仍然是一个重大的健康问题。据估计,2016年,有3.7亿人患有衣原体、淋病和滴虫病;还有7.08亿人患有生殖器疱疹和尖锐湿疣。据报道,在孕妇中,GTI与早产有关。需要进一步了解GTI相关早产的机制,以预防新生儿死亡率和发病率,这可能是新生儿生长发育障碍的风险因素。本文旨在描述各种类型的GTI及其相关的早产发病机制。进行文献检索,从Pubmed、ScienceDirect和Google Scholar等在线数据库中检索最近发表的英文文章。这项文献研究发现,GTI引起炎症反应,触发导致早产的几种机制。GTI的炎症反应包括促炎细胞因子的产生和中性粒细胞的强烈激活。GTI中刺激早产的关键机制包括早期子宫收缩、早产胎膜早破和诱导宫颈成熟;在足月妊娠的正常情况下,这些机制受到孕酮和前列腺素水平以及炎症反应抑制的调节。总之,本文描述了患有ISG的孕妇早产的潜在机制。然而,念珠菌和淋球菌感染的这种机制尚不清楚;因此,需要进一步研究。
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Genital Tract Infection during Pregnancy and its Association with Preterm Delivery
Genital tract infection (GTI) remains a significant health concern. It is estimated that in 2016, there were 370 million people who suffer from chlamydia, gonorrhea, and trichomoniasis; and 708 million others suffer from genital herpes and condyloma acuminatum. It has been reported that in pregnant women, GTI is associated with preterm delivery. The mechanisms of GTI-associated preterm delivery need to be further understood to prevent neonatal mortality and morbidity that could be the risk factor for neonates’ growth and development disorders. This article aims to describe various types of GTI and the associated pathogenesis causing preterm birth. A literature search was conducted to retrieve recent articles published in English from online databases including Pubmed, ScienceDirect, and Google Scholar. This literature study found that GTI evokes inflammatory responses that trigger several mechanisms leading to preterm delivery. The inflammatory responses in GTI include the production of proinflammatory cytokines and robust activation of neutrophils. The key mechanisms that stimulate preterm delivery in GTI include the events of early uterine contraction, preterm premature rupture of membranes, and induction of cervical ripening; which are under normal circumstances in a full-term pregnancy, those mechanisms are regulated by progesterone and prostaglandin levels along with suppression of the inflammatory responses. In conclusion, this paper has described the underlying mechanisms of preterm delivery in pregnant women with ISG. However, such mechanisms remain unclear in candida and gonococcal infection; thus, prompting the need for further studies.
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