Prevalência e fatores associados de processosinflamatórios/infeccioso do trato genital inferior em gestantes

• Autor(a) principal: Ribeiro, Flávia Teixeira
• Data de Publicação: 2013
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da Universidade Estadual de Maringá (RI-UEM)
• Texto Completo: http://repositorio.uem.br:8080/jspui/handle/1/2095
• topic: Gestação; Fatores de risco; Sinais e sintomas; Vaginose bacteriana; Candidíase; Brasil.; Pregnancy; Risk factors signs and symptoms; Bacterial vaginosis; Candidiasis; Brazil.; Ciências da Saúde; Medicina

The infection of the lower genital tract may contribute from 25.0% to 40.0% of preterm births. The most common infections are bacterial vaginosis (BV), vulvovaginal candidiasis (VC) and trichomoniasis, responsible for 90% of the cases. The objective of this work is to analyze the prevalence and factors associated with the vaginal infections of the lower genital tract in pregnant women. This is a descriptive, quantitative and cross-sectional study, developed in a municipality of northern Parana, during the period from July to November of 2013. The sample was composed of 196 pregnant women. The data collection occurred through a questionnaire and the collection of vaginal secretion. Crude analysis, odds ratio (OR), Chi-Square test and Fisher's exact test were performed. The prevalence of vulvovaginitis was of 47.9 %, and the most prevalent were VC (60.7 % ), BV (33 %) and a mixed infection of VC and BV (6.3 %).The significant result obtained was the variable marital status (p= 0.04) (OR= 2.3 CI95 % = 1.02 -5,31) and regarding the gynecological and obstetric aspects, it was observed that the age of the first sexual relation &#8804; 15 years is associated with the presence of vulvovaginitis in pregnancy (OR = 2.7, 95% CI = 1.51 -5,13). In the logistic regression model the factors marital status and age of the first sexual relation &#8804; 15 years associated with the vulvovaginitis were analyzed. Pregnant women without husbands and those whose ages of the first sexual relation were &#8804; 15 years presented a risk of 2.3 and 2.8, respectively, for the development of vulvovaginitis. Considering the interaction between the variables marital status and age of the first sexual relation, it was observed that for pregnant women with companion and first sexual relation &#8804; 15 years, that represented a protective factor for the presence of vulvovaginitis in pregnancy, on the other hand, for pregnant women without companions and first sexual relation &#8804; 15 years, that represented a risk factor for vaginal infections in pregnancy. The occurrence of signs and symptoms among pregnant women with vulvovaginitis was reported by 43.3% of the pregnant women, prevailing VC (26.0 %), BV (14.2 %) and mixed infection (VC and BV) (3.0 %). It was observed that the pregnant women with normal vaginal flora showed signs or symptoms of vulvovaginitis (p= 0.04). The relationship between the laboratory diagnosis and the signs and symptoms of VC among the pregnant women was significant, itching (p= < 0.01) and burning sensation (p= < 0.01), with an OR= 4.54 (95% CI = 2,17 -9,56) and OR=3.32 (95% CI = 1,62 -6,84), respectively. Another important finding was the fissure OR=2.67 (95% CI 0,85 -8,38). Regarding the signs and symptoms associated to the BV among pregnant women, only fetid odor had a significant result (p= 0.04) and OR=2.26 (95% CI = 0,94 -5,37). In our study there was a high prevalence of vaginal infections among pregnant women, important information for the assistance during pre-natal care. The factors associated to vulvovaginitis are also instructive in helping to identify the risk criterion, because we are aware that there is evidence that the premature birth may be associated with the vulvovaginitis. Therefore, it is suggested the implementation of a tracking program for vulvovaginitis in pregnant women.