围生期母婴B族链球菌筛查及干预疗效评价

Evaluation on Perinatal Group B Streptococcus Screening and the Intervention Effect

目的了解孕晚期B族链球菌(GBS)感染率及抗菌素干预后的母婴结局。方法对2 026名孕35~37周孕妇进行GBS带菌状况筛查,以GBS阳性237例为研究组,其中GBS阴性1 000例为对照组,阳性患者临产和(或)破膜时使用抗菌素,对照组不干预。观察羊膜腔感染、产褥感染率以及新生儿肺炎、脓毒血症、败血症、脑膜炎发生率及GBS阳性率。结果妊娠35~37周孕妇GBS阳性率为11.7%(237/2 026);经抗菌素干预治疗后研究组的羊膜腔感染、产褥感染以及新生儿肺炎、脑膜炎、脓毒血症/败血症发生率分别为0.4%、0.8%、0.4%、0.0%、0.0%,对照组为0.5%、1.1%、0.7%、0.0%、0.1%,两组比较无统计学差异(P>0.05)。研究组新生儿口咽鼻分泌物GBS培养阳性率3.0%,显著高于对照组的0.2%(P<0.05)。结论对孕晚期GBS阳性孕妇临产和(或)破膜时给予敏感抗菌素干预治疗可有效预防母婴感染。

Objective To investigate the Group B streptococcus （GBS） infection rate at late pregnancy, and the maternal and neonatal outcomes after intervention. Methods 2 026 cases of pregnant women with 35 - 37 weeks gestation received GBS screening. According to the screening results, 1 000 negative cases were set as the control group, and 237 positive cases were set as the study group. Positive cases received antibiotics at the time of labor and （or） rupture of membrane, and the control group did not received intervention. The rates of maternal amniotic infection and puerperal infection, incidences of neonatal pneumonia, sepsis / septicemia and meningitis, and neonatal GBS positive rate were observed. Results The GBS positive rate of pregnant women with 35 - 37 weeks gestation was 11.7% （237/2 026）. After antibiotics intervention, the rates of maternal amniotic infection and puerperal infection, and incidences of neonatal pneumonia, meningitis, and sepsis / septicemia of study group were 0.4%, 0.8%, 0.4%, 0.0% and 0.0% respectively, which had no statistical difference with the control group （0.5%, 1.1%, 0.7%, 0.0% and 0.1% respectively）, all P〉0.05. The neonatal GBS positive rate was 3.0% in study group, and 0.2% in control group （P〈0.05）. Conclusions Sensitive antibiotics intervention for late pregnant women with positive GBS in labor and （or） rupture of membrane can effectively prevent the mother and child infection.