B族链球菌筛查与治疗对妊娠结局的影响

The effect of streptococci screening and treatment on pregnancy outcome

目的:探讨广西地区妊娠晚期妇女B族链球菌(GBS)带菌状况及干预对母婴预后的影响,为广西地区是否需行GBS普遍性筛查提供依据。方法:收集2015年1月至2017年6月在本院产检、年龄22~36岁、孕周36~42周,在妊娠35~37周之间已行GBS检测的孕妇,分两阶段,2015年10月前未进行干预治疗、GBS结果阳性者作为GBS阳性组,共222例;GBS结果阴性者作为GBS阴性组,共2 208例。2015年11月至2017年6月共收集GBS阳性孕妇214例(GBS阳性干预组),分娩前至少4h接受抗生素静脉注射。观察两阶段母婴预后情况。结果:GBS阳性组、GBS阴性组和GBS阳性干预组宫内感染、胎膜早破、早产、产后出血、产褥感染、剖宫产、新生儿感染、胎儿生长受限、胎儿窘迫、新生儿死亡率差异均有统计学意义(P<0.05)。结论:GBS感染可明显增加孕妇宫内感染、胎膜早破、早产、产后出血、产褥感染、剖宫产及新生儿感染的发生率,经对孕晚期孕妇进行筛查,并于产时积极干预治疗,能有效减少母儿并发症的发生。

Objective:To investigate late pregnancy women's group B streptococcus(GBS)pathogen and its effects on maternal and infant prognosis condition in Guangxi.Methods:22 to 36 years old pregnant women underwent prenatal examination in our hospital from January 2015 to June 2017 were selected.The GBS test performed at 35 to 37 weeks of pregnancy.The women without treatment intervention before October 2015 were divided into GBS positive group(n=222)and GBS negative group(n=2,208).From November 201 5 to June 2017,214 cases received antibiotic treatment(intervention group)were GBS positive.The maternal and infant outcomes were observed and compared.Results:There were significant differences in the rates of intrauterine infection,premature rupture of membranes,preterm labor,postpartum hemorrhage and puer-peral infection,the incidence of cesarean section and neonatal infections among the three groups(P〈0.05).Conclusion:GBS infection could obviously increase the risks of intrauterine infection,premature rupture of membranes,preterm labor,postpartum hemorrhage and puerperal infection,the incidence of cesarean sec-tion and neonatal infections.Screening for GBS infection at 35-37 weeks gestation and taking positive inter-vention could effectively reduce the occurrence of complications.