关键词: 妊娠期妇女, 生殖道真菌感染, 病原菌, 危险因素

Abstract: Objective To investigate the distribution of pathogenic fungi and risk factors for genital tract fungal infections in women during pregnancy, with a view to improve guidance for clinical prevention and treatment of genital tract fungal infections during pregnancy. Method A total of 136 pregnant women with genital tract fungal infections attending our Obstetrics and Gynecology Clinic of Fuyang Women and Children's Hospital from May 2021 to May 2024 were retrospectively selected as the infected group, and another 174 pregnant women who did not develop infections during the same period were randomly selected as the uninfected group. Clinical data of all pregnant women were collected, risk factors were analyzed by multivariate logistic regression model, the predictive value was assessed by using receiver operating characteristic curve (ROC curve), and a decision tree model was constructed based on risk factors. Result A total of 149 fungal strains were detected in 136 pregnant women with genital tract fungal infections, of which Candida albicans was most common with 72 strains (48.32%). Univariate analysis showed that genital tract fungal infections in pregnant women were associated with age, gestational week, history of miscarriage, BMI, comorbid diabetes mellitus, history of reproductive tract infections, pre-pregnancy contraceptive use, long-term use of antibiotics, regular change of underwear, and exposure to health education during pregnancy, and the differences were statistically significant (all P<0.05); genital tract fungal infections in pregnant women were associated with history of labor and delivery, literacy level, comorbid hypertension, comorbid anemia, comorbid thyroid function abnormalities, and condom use during pregnancy were not related, and the differences were not statistically significant (all P>0.05). Logistic regression modeling multifactorial results showed that age ≥35 years (OR=2.453), gestational weeks ≥28 weeks (OR=2.708), history of miscarriage (OR=3.260), BMI ≥25kg/m² (OR=3.202), comorbid diabetes mellitus (OR=2.075), history of reproductive tract infections (OR=2.457), pre-pregnancy contraceptive use (OR=1.766), long-term use of antibiotics (OR=1.976), non-regular underwear change (OR=2.627), and failure to be exposed to health education during pregnancy (OR=2.196) were risk factors for genital tract fungal infections in pregnant women (P<0.05). ROC curve analysis showed that the area under curve (AUC) of the above risk factors jointly predicted genital tract fungal infections in pregnant women was 0.803, with a 95% CI of 0.754-0.852, sensitivity of 0.741, and specificity of 0.743. The decision tree model showed that age ≥35 years was the most important predictor, and the classification accuracy of the model was 81.60%. Conclusion Age ≥35 years, gestational weeks ≥28 weeks, history of miscarriage, BMI ≥25kg/m², comorbid diabetes mellitus, history of reproductive tract infections, pre-pregnancy use of contraceptives, long-term use of antibiotics, non-regular underwear change, and lack of exposure to health education during pregnancy are the risk factors for with genital tract fungal infections in pregnant women, and clinical attention should be paid to women with the above-mentioned risk factors in pregnancy and to actively prevent of genital tract fungal infections.

Key words: Pregnant women, Genital tract fungal infections, Pathogenic fungi, Risk factors