妊娠期B族链球菌感染的高危因素及其对新生儿预后影响分析

High risk factors of group B streptococcus infection during pregnancy and its effect on neonateal prognosis

目的探讨孕妇妊娠期感染B族链球菌的高危因素,及其对新生儿预后的影响。方法选取2014年1月至2015年12月在东莞市妇幼保健院产检发现妊娠期B族链球菌筛查阳性并在我院分娩的孕妇93例为感染组,另选取同时期在我院产检妊娠期B族链球菌筛查阴性的孕妇78例为对照组,对比两组孕妇的年龄、文化程度、是否伴有阴道炎、糖尿病等临床资料,分析孕妇妊娠期感染B族链球菌的高危因素,并对比两组孕妇新生儿结局。结果经单因素分析显示,与妊娠期感染B族链球菌相关的因素可能有年龄、文化程度、流产史、孕前检查、家庭住址、阴道炎(χ~2值分别为5.942、11.727、4.168、14.380、4.203、8.129,均P<0.05)。经多因素分析显示,孕前检查为妊娠期感染B族链球菌的保护因素(OR=0.337,P<0.05),年龄较高、存在流产史及阴道炎是妊娠期感染B族链球菌的危险因素(OR值分别为1.618、1.955、1.217,均P<0.05)。感染组孕妇产褥感染、胎膜早破及早产的发生率显著高于对照组(χ~2值分别为4.357、4.318,均P<0.05)。感染组胎儿宫内窘迫、新生儿窒息、新生儿肺炎及新生儿黄疸的发生率显著高于对照组(χ~2值分别为4.559、4.207,均P<0.05)。结论妊娠期B族链球菌的感染会增加新生儿不良预后的发生率,其高危因素有年龄、阴道炎、流产史,应根据高危因素制订相应干预措施,以改善新生儿预后。

Objective To investigate the high risk factors of group B streptococcus（GBS） infection in women during pregnancy and to analyze its influence on neonatal prognosis. Methods Ninety-three cases of pregnant women with positive GBS screening in pregnancy checkup and undergoing childbirth in Dongguan Maternal and Child Health Care Hospital from January 2014 to December 2015 were assigned to infection group,and 78 cases of pregnant women with negative GBS screening in checkup implemented in same hospital at same period as control group. Clinical data of pregnant women in two groups such as maternal age,degree of education,whether or not suffering from vaginitis or diabetes were compared. High risk factors of GBS infection during pregnancy were analyzed and maternal and neonatal outcomes in two groups were compared. Results Single factor analysis showed that factors including age,education level,history of abortion,pre-pregnancy checkup,home address and vaginitis were possibly associated with pregnancy GBS infection（χ~2value was 5. 942、11. 727、4. 168、14. 380、4. 203、8. 129,respectively,all P〈0. 05）. Multi-factor analysis showed that pre-pregnancy checkup was protective factor for GBS infection during pregnancy（OR = 0. 337,P〈0. 05）,and older age,history of abortion and vaginitis were risk factors for GBS infection during pregnancy（OR value was 1. 618,1. 955 and 1. 217,respectively,all P〈0. 05）. Incidences of puerperal infection,premature rupture of fetal membrane and premature delivery of pregnant women in the infection group were significantly higher than those in the control group（χ~2value was 4. 357 and 4. 318,respectively,both P〈0. 05）. Incidences of fetal distress,neonatal asphyxia,neonatal pneumonia and neonatal jaundice in the infection group were significantly higher that those in the control group（χ~2value was 4. 559 and 4. 207,respectively,both P〈0. 05）. Conclusion Infection of GBS during pregnancy may increase the incidence of adverse prognosis in neonates. High risk factors of GBS infection during pregnancy include maternal age, vaginitis and abortion history.Corresponding intervention measures should be made according to risk factors to improve neonatal prognosis.