围产期孕妇B群链球菌感染对妊娠结局影响分析

Impact analysis of group B Streptococcus infection on the outcome in perinatal women

目的探讨围产期孕妇B群链球菌感染情况,为妊娠结局的临床研究分析提供理论依据。方法选取2013年1月-2015年1月在医院接受产检725例围产期孕妇为研究对象;采用细菌培养法及实时定量聚合酶链反应法(RT-PCR)对围产期孕妇B群链球菌进行检测,分析B群链球菌对围产期孕妇妊娠结局的影响。结果采用细菌培养B群链球菌阳性36例,阳性率为4.97%,使用RT-PCR检测阳性80例,阳性率为11.03%,两种检测方式检测结果比较,差异有统计学意义(P<0.05);细菌培养和RT-PCR检测B群链球菌的特异性、灵敏度及准确度比较,差异有统计学意义(P<0.05);RT-PCR检测的GBS阳性围产期孕妇宫内感染、产后出血、早产、胎儿窘迫、新生儿感染的发生率分别为16.25%、17.5%、2.5%、36.25%、13.75%。结论采用RT-PCR方法对围产期孕妇B群链球菌的检测效果更好,结果准确率高、特异性优;围产期孕妇GBS感染,会使产后出血率高,增加子宫感染的概率,同时新生儿的畸形率升高,围产期孕妇携带B群链球菌对妊娠结局有着重要的影响,在临床中值得关注。

OBJECTIVE To investigate the group B Streptococcus infection in perinatal women, so as to provides a theoretical basis for the clinical studies of pregnancy outcomes. METHODS A total of 725 cases of perinatal women from Jan. 2013 to Jan. 2015 in our hospital were selected as the objects of study. Bacterial cultures and real-time quantitative polymerase chain reaction （RT-PCR） were used for positive test of group B Streptococcus in perinatal women, and the impact of group B Streptococcus to pregnancy outcome in perinatal women was analyzed. RESULTS There were 36 cases of positive group B Streptococcus bacterial were cultured, and the positive rate was 4. 97%. RT-PCR detected out 80 cases positive, and the positive rate was 11.03%, and the difference was signifi- cant in these two ways （P〈0.05）. The comparison of specificity, sensitivity and degree of accuracy between bac- terial cultures and RT-PCR to check the group B Streptococcus had significant difference （P〈0.05）. The inci- dence rates of intrauterine infection, postpartum hemorrhage, fetal distress and neonatal infection in GBS positive perinatal women by RT-PCR were16.25%, 17.5%, 2.5%, 36.25% and 13.75%. CONCLUSION RT-PCR meth- od is better for perinatal women to have detection results of group B Streptococcus with high accuracy, excellent specificity. The group B Streptococcus infection in perinatal women will have higher postpartum hemorrhage rate, increasing the probability of infection of the uterus, as well as higher malformation rate of neonatal. The group B Streptococcus in perinatal women has important implications on pregnancy outcome, which is worth to concern in the clinical application.