妊娠晚期不同时期B族链球菌感染对妊娠结局的影响研究

Influence of Group B Streptococcus Infection on Pregnancy Outcome in Different Stages of Late Pregnancy

目的:探讨妊娠晚期孕妇生殖道B族溶血性链球菌(GBS)感染对妊娠结局的影响。方法:收集2018年1-12月在佛山市禅城区中心医院产科门诊就诊的妊娠晚期孕妇250例。分别于28~32周及35~37周使用消毒棉签拭子采集阴道分泌物及肛周分泌物进行GBS筛查,随机抽取孕28~32周及35~37周检测GBS均为阴性孕妇100例设为阴性对照组,随机抽取孕28~32周检测GBS阳性但35~37周检测GBS为阴性孕妇50例设为A组,随机抽取孕28~32周检测GBS阴性但35~37周检测GBS为阳性孕妇50例设为B组,随机抽取孕28~32周及35~37周检测GBS均为阳性孕妇50例设为C组。分析各组孕妇的妊娠结局,包括胎膜早破、羊水污染、产后出血、早产、新生儿肺部感染、产褥感染的发生情况。结果:与对照组对比,A组、B组、C组孕妇胎膜早破、羊水污染、早产、新生儿肺部感染、产褥感染发生率均较高,差异有统计学意义(P<0.05)。与C组对比,A组孕妇胎膜早破、羊水污染、新生儿肺部感染发生率较低,差异有统计学意义(P<0.05);B组孕妇羊水污染发生率较低,差异有统计学意义(P<0.05)。与B组对比,A组孕妇胎膜早破、新生儿肺部感染发生率较低,差异有统计学意义(P<0.05)。结论:妊娠晚期不同时期GBS感染对妊娠结局影响有所差异,感染持续时间越长,对妊娠结局影响越明显。感染时间越迟,对胎膜早破、新生儿肺部感染影响越明显。

Objective:To investigate the effect of genital tract group B hemolytic streptococcus(GBS) infection on pregnancy outcome in late pregnancy.Method:The 250 cases of late pregnant women in obstetric clinic of Chancheng District Central Hospital of Foshan City from January to December 2018 were collected.They were used sterile cotton swab to collect vaginal and perianal secretions for GBS screening at 28-32 weeks and 35-37 weeks,respectively.The 100 pregnant women with GBS negative at 28-32 weeks and 35-37 weeks of gestation were randomly selected as negative control group.The 50 pregnant women with GBS positive at 28-32 weeks of gestation but negative at 35-37 weeks of gestation were randomly selected as group A.The 50 pregnant women with negative GBS at 28-32 weeks of gestation but positive GBS at 35-37 weeks of gestation were randomly selected as group B.The 50 pregnant women with positive GBS at 28-32 weeks and 35-37 weeks of gestation were randomly selected as group C.The pregnancy outcomes,including premature rupture of membranes,amniotic fluid contamination,postpartum hemorrhage,premature delivery,neonatal infection,neonatal asphyxia and puerperal infection were analyzed.Result:Compared with the control group,the incidence of premature rupture of membranes,amniotic fluid pollution,premature delivery,neonatal infection and puerperal infection of pregnant women in group A,group B and group C were higher(P<0.05).Compared with group C,the incidence of premature rupture of membranes,amniotic fluid pollution,neonatal infection in group A was lower,the difference was statistically significant(P<0.05).In group B the incidence of amniotic fluid pollution was lower,the difference was statistically significant(P<0.05).Compared with group B,the incidence of premature rupture of membranes and neonatal pulmonary infection in group A was lower(P<0.05).Conclusion:The relationship between GBS infection and pregnancy outcome is different in different stages of late pregnancy.The longer the duration of infection,the more obvious the effect on pregnancy outcome.The later the time of GBS infection,the more obvious the impact on premature rupture of membranes and neonatal pulmonary infection.