妊娠晚期B族链球菌感染对孕妇阴道清洁度及不良妊娠结局的影响

Relation of group B Streptococcus and vaginal clearing degree and adverse pregnancy outcome

目的:探讨妊娠晚期阴道B族链球菌(group B Streptococcus,GBS)感染与阴道清洁度及不良妊娠结局的关系。方法:选择2012年6月至2014年8月在上海市嘉定区妇幼保健院产科检查及分娩的孕35周以上的孕妇共1 864例,常规进行阴道清洁度检测及GBS培养。比较阴道清洁度异常组与正常组孕妇GBS带菌率的情况。观察GBS(+)组与GBS(-)组孕妇胎膜早破、早产、产褥感染的发生情况。结果:1 864例中,GBS阳性率5.15%(96/1 864)。阴道清洁度正常孕妇1 057例,其中GBS阳性率3.60%(38/1 057);阴道清洁度异常孕妇807例,其中GBS阳性率7.19%(58/807),差异有统计学意义(P=0.001)。GBS感染孕妇胎膜早破与产褥感染的发生增加(P<0.05),发生风险[比值比(odds ratio,OR)]分别增加13.40倍、2.20倍。结论:阴道清洁度异常者GBS带菌率更高;妊娠晚期GBS感染对围产期结局有不良影响,妊娠晚期应加强GBS检测。

Objective：To discuss the relationship between vaginal colonization of group B Streptococcus（GBS）and vaginal clearing degree,and the adverse pregnancy outcome.Methods：Totally 1864 cases of pregnant women after 35 weeks taking regular prenatal and delivery in Department of Gynecology,Maternal and Child Health Hospital of Jiading District in Shanghai City from Jun.2012 to Aug.2014 were enrolled.The vaginal clearing degree and GBS was detected regularly.The GBS carrier rates were compared between the two groups of normal and abnormal vaginal clearing degree.The incidences of premature rupture of membranes,premature delivery and puerperal infection were observed in GBS positive and negative groups.Results：In the 1864 cases,the GBS positive rate was 5.15% （96/1864）.In 1057 cases of pregnant women with normal vaginal clearing degree,GBS positive rate was 3.60%（38/1057）.In the 807 cases with abnormal clearing degree,the GBS positive rate was 7.19%（58/807,P= 0.001）.The incidences of premature rupture of membranes and puerperal infection of pregnant women with GBS infection increased （P〈0.05）,and the risk （odds ratio,OR）increased by 13.40 times,2.20 times,respectively.Conclusions：GBS carrier rate of pregnant women with abnormal vaginal cleaning degree is higher.GBS infection had adverse effects on perinatal outcome.It suggests that GBS detection in the late pregnancy is necessary.