B族链球菌预防性治疗对妊娠晚期GBS检测阳性孕妇母婴结局的影响

Effect of Group B Streptococci Preventive Treatment on Maternal and Infant Outcomes of Pregnant Women with Positive GBS Test in the Third Trimester of Pregnancy

目的:探讨B族链球菌(group B streptococci,GBS)预防性治疗对妊娠晚期GBS检测阳性孕妇母婴结局的影响。方法:选取本院2018年1-12月收治的妊娠晚期GBS检测阳性者100例的临床资料进行回顾性分析,根据是否进行GBS预防性治疗分为对照组与研究组。50例未接受GBS预防性治疗作为对照组,50例接受GBS预防性治疗作为研究组。比较两组新生儿结局、分娩情况,并分析早产儿中GBS感染情况。结果:研究组胎儿生长受限、新生儿窒息、胎儿窘迫及新生儿感染发生率均低于对照组(P<0.05);研究组胎膜早破、产后出血、产褥感染、剖宫产及早产发生率均低于对照组(P<0.05);≥34周且<37周早产儿GBS定植阳性率明显低于<34周早产儿,且抗GBS荚膜多糖抗体水平明显高于<34周早产儿(P<0.05)。结论:B族链球菌预防性治疗能有效改善妊娠晚期GBS检测阳性孕妇的母婴结局,早产儿GBS感染阳性率及抗GBS荚膜多糖抗体水平与胎龄相关,应重视GBS检测阳性孕妇分娩的早产儿GBS筛查,并及时给予治疗。

Objective:To investigate the effect of group B streptococci (GBS) preventive treatment on maternal and infant outcomes of pregnant women with positive GBS test in the third trimester of pregnancy.Method:The clinical data of 100 cases of GBS positivity in the third trimester of pregnancy admitted to our hospital from January to December 2018 were analyzed retrospectively.They were divided into control group and research group according to whether treated with GBS preventive treatment in the first trimester of pregnancy.50 cases did not receive GBS preventive treatment as control group,and 50 cases received GBS preventive treatment as research group.Neonatal and delivery outcome were compared between the two groups.GBS infection in premature infants was analyzed.Result:The incidence of fetal growth restriction,neonatal asphyxia,fetal distress and neonatal infection in the research group were lower than those in the control group (P<0.05).The incidence of premature rupture of membranes,postpartum hemorrhage,puerperal infection,cesarean section and premature delivery in the research group were lower than those in the control group (P<0.05).The positive rate of GBS colonization in preterm infants ≥34 weeks and <37 weeks was significantly lower than that in preterm infants <34 weeks,and the level of anti-GBS capsular polysaccharide antibody was significantly higher than that in preterm infants <34 weeks (P<0.05).Conclusion:Preventive treatment of GBS can effectively improve maternal and infant outcomes of pregnant women infected with GBS in the third trimester of pregnancy,the positive rate of GBS infection in premature infants and the level of anti-GBS capsulated polysaccharide antibody are related to gestational age,attention should be paid to GBS screening and timely treatment of premature infants delivered by pregnant women with GBS infection.