妊娠晚期孕妇B族链球菌带菌危险因素及对妊娠结局的影响

Risk factors of group B Streptococcus among late pregnant women and its effect on pregnancy outcomes

目的分析妊娠晚期孕妇B族链球菌(GBS)的带菌情况、危险因素及对妊娠结局的影响。方法前瞻性分析2015年9月-2016年6月在该院就诊的妊娠晚期孕妇794例资料,采用聚合酶链反应(PCR)检测阴道和直肠分泌物标本,将GBS阳性111例纳入观察组,随机抽取同期产检检测GBS为阴性的111例纳入对照组。分析GBS带菌的高危因素及妊娠结局。结果(1)794例孕妇中,GBS阳性率为13.98%(111/794)。(2)两组年龄、孕次、孕周、产次、流产次数方面比较差异无统计学意义(P>0.05);对照组年龄≥35岁、经产妇、阴道炎及妊娠期糖尿病的比例显著低于观察组(P<0.05);多因素回归分析显示,年龄≥35岁、经产妇、阴道炎及妊娠期糖尿病为GBS带菌的危险因素。(3)两组早产、产后出血发生率比较差异无统计学意义(P>0.05);观察组胎膜早破、绒毛膜羊膜炎、新生儿感染发生率较对照组显著提高(P<0.05)。结论高龄、经产妇、阴道炎、妊娠期糖尿病为妊娠晚期孕妇GBS带菌的危险因素,妊娠晚期孕妇GBS带菌会增加胎膜早破、绒毛膜羊膜炎、新生儿感染等不良妊娠结局,故妊娠晚期对孕妇进行GBS筛查非常重要。

Objective To analyze the status,risk factors of group B Streptococcus（GBS） among late pregnant women and the impact on pregnancy outcomes.Methods The clinical data of 794 late pregnant women from the hospital from September 2015 to June 2016 were analyzed retrospectively.Vaginal and rectal secretion samples were detected by polymerase chain reaction（PCR）.A total of 111 GBS positive pregnant women were enrolled into observation group,while 111 GBS negative pregnant women were randomly selected as control group during the same period.The high-risk factors and pregnancy outcomes were analyzed.Results The positive rate of GBS was 13.98%（111/794） in 794 pregnant women.There was no statistically significant difference in age,gravidity,gestational week,parity,and abortion times between the two groups（P〈 0.05）.The proportions of pregnant women aged 35 years old or more than 35 years old,multipara,pregnant women with vaginitis and gestational diabetes mellitus（GDM） in control group were statistically significantly lower than those in observation group（P〈 0.05）.Multivariate regression analysis showed that age≥35 years old,multipara,vaginitis,and GDM were the risk factors of GBS infection.There was no statistically significant difference in the incidence rates of premature delivery and postpartum hemorrhage between the two groups（P〈 0.05）.The incidence rates of premature rupture of membranes,chorioamnionitis,and neonatal infection in observation group were statistically significantly higher than those in control group（P〈 0.05）.Conclusion Advanced age,multipara,vaginitis,and GDM are risk factors of GBS among late pregnant women,GBS infection will increase the incidence rates of premature rupture of membranes,chorioamnionitis,neonatal infection,and other adverse pregnancy outcomes in late pregnant women,therefore,GBS screening among late pregnant women is very important.