最近,瑞士洛桑大学医院的David Baud等在美国疾病控制与预防中心(CDC)的《新发感染性疾病》杂志Emerg Infect Dis发表论文"Role of Chlamydia trachomatis in Miscarriage"证实流产与血清学/分子学显示的存在沙眼衣原体感染相关联,这项研究成果支持了沙眼衣原体感染在流产中的作用。
为确定沙眼衣原体在流产中的作用,研究人员前瞻性收集了386名流产或未流产妇女的血清、宫颈拭子标本和胎盘样本。
结果:流产组中的抗沙眼衣原体免疫球蛋白G流行率较对照组高(15.2%对7.3%,P = 0.018)。对年龄、出生、受教育情况和性伴侣数校正后,沙眼衣原体血清学阳性结果与流产的关系依然显著【比值比(OR):2.3】。流产妇女的妊娠产物或胎盘中沙眼衣原体DNA被扩增情况较对照组频繁(4%对0.7%;P = 0.026)。免疫组化分析证实,7例聚合酶链反应(PCR)结果阳性的患者中5例患者的胎盘感染了沙眼衣原体,而在全8例阴性对照检测者的胎盘样本中免疫组化分析结果均为阴性。(生物谷Bioon.com)
doi:10.3201/eid1709.100865
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Role of Chlamydia trachomatis in Miscarriage
David Baud, Genevieve Goy, Katia Jaton, Maria-Chiara Osterheld, Serafin Blumer, Nicole Borel, Yvan Vial, Patrick Hohlfeld, Andreas Pospischil, and Gilbert Greub
To determine the role of Chlamydia trachomatis in miscarriage, we prospectively collected serum, cervicovaginal swab specimens, and placental samples from 386 women with and without miscarriage. Prevalence of immunoglobulin G against C. trachomatis was higher in the miscarriage group than in the control group (15.2% vs. 7.3%; p = 0.018). Association between C. trachomatis–positive serologic results and miscarriage remained significant after adjustment for age, origin, education, and number of sex partners (odds ratio 2.3, 95% confidence interval 1.1–4.9). C. trachomatis DNA was more frequently amplified from products of conception or placenta from women who had a miscarriage (4%) than from controls (0.7%; p = 0.026). Immunohistochemical analysis confirmed C. trachomatis in placenta from 5 of 7 patients with positive PCR results, whereas results of immunohistochemical analysis were negative in placenta samples from all 8 negative controls tested. Associations between miscarriage and serologic/molecular evidence of C. trachomatis infection support its role in miscarriage.