妊娠晚期孕妇阴道微生态失调与B族链球菌感染对母婴结局的影响

The effects of vaginal microecological imbalance and group B streptococcus infection during the third trimester of pregnancy on maternal and infant outcomes

目的:分析妊娠晚期孕妇阴道微生态失调和B族链球菌(GBS)感染对母婴结局的影响。方法:收集2016年5月—2018年5月在本院产科行孕期产检并计划分娩的妊娠晚期孕妇,采集孕妇阴道侧壁上1/3处及肛周分泌物,行阴道分泌物微生物检查,采用实时荧光PCR-探针法行GBS检查。分析阴道微生态失调和GBS感染对母婴结局影响。结果:318例孕妇中,微生态失调21.1%,GBS感染率9.8%;阴道pH值异常发生率,阴道微生态失调孕妇(61.2%)高于微生态正常孕妇(23.5%),GBS阳性孕妇(67.7%)高于GBS阴性孕妇(27.5%)(均P<0.05);剖宫产、胎膜早破、胎儿窘迫、产后出血发生率及新生儿黄疸、窒息、肺炎发生率,阴道微生态失调孕妇均高于微生态正常孕妇,GBS阳性孕妇均高于GBS阴性孕妇(均P<0.05)。结论:妊娠晚期孕妇阴道微生态失调和GBS感染与母婴不良妊娠结局有关。

Objective:To analyze the effects of vaginal microecological imbalance and group B streptococcus(GBS) infection during the third trimester of pregnancy on maternal and infant outcomes. Methods: 318 pregnant women during the third trimester of pregnancy were selected as the study subjects from May 2016 to May 2018. The secretions 1/3 from the vaginal side wall and crissum of pregnant women were collected and conducted microbiological examination. The real time fluorescent PCR-probe method was used for GBS tested. The effects of vaginal microecological imbalance and GBS infection on maternal and infant outcomes were analyzed. Results: Among the 318 pregnant women, 21.1% women had microecological imbalance, and the GBS infection rate was 9.8%. The incidence of abnormal vaginal pH of women with vaginal microecological disorders or positive GBS infection was 61.2% or 67.7%, which was significant higher than that(23.5% or 27.5%) of women with normal microecological conditions or negative GBS infection(all P<0.05). The incidences of cesarean section, premature rupture of membranes, fetal distress, postpartum hemorrhage, and neonatal jaundice, asphyxia, and pneumonia of women with vaginal microecological disorders or positive GBS infection were significant higher than those of women with normal microecological conditions or negative GBS infection(all P<0.05). Conclusion: Vaginal microecological imbalance and GBS infection of women during the third trimester of pregnancy are closely related to adverse maternal and infant outcomes.