妊娠期B族溶血性链球菌感染的危险因素分析及妊娠结局的影响

Risk factors of group B streptococcus infection during pregnancy and the influence of pregnancy outcome

目的探讨妊娠期B族溶血性链球菌(GBS)感染的危险因素,分析GBS感染对妊娠结局的影响。方法选择2018年1月—2019年12月都市妇女儿童中心医院产科门诊接诊的15200例孕妇为研究对象。根据抗原检测结果,将其分为GBS抗原检测阳性920例(感染组),GBS抗原检测阴性14280例(对照组)。收集受试者临床资料,多元logistic回归分析影响妊娠期GBS感染的危险因素,追踪妊娠结局及母婴临床结局。结果感染组年龄≥35岁、流产史、合并阴道炎、妊娠期糖尿病、阴道微生态评分(Nugent评分)≥4分患者比例高于对照组(均P<0.05);本科及以上文化程度、居住城镇、参与围生期保健比例低于对照组(均P<0.05)。多元logistic回归分析结果显示年龄≥35岁、有流产史、合并阴道炎、妊娠期糖尿病、Nugent评分≥4分是妊娠期GBS感染的高危因素(OR=1.865、2.073、15.656、14.129、14.089,均P<0.05)。感染组剖宫产、早产、低出生体重儿、新生儿GBS感染发生率均高于对照组(均P<0.05)。结论妊娠期GBS感染率较高,高龄产妇、流产史、合并阴道炎、妊娠期糖尿病、Nugent评分高是GBS感染高危人群,发生不良妊娠结局风险较大。

Objective To explore the risk factors of group B streptococcus(GBS)infection during pregnancy and analyze the effect of GBS infection on pregnancy outcome.Methods From January 2018 to December 2019,15200 pregnant women who received treatment in Department of Obstetrics,Chengdu Women′s and Children′s Central Hospital were selected as the study objects.According to the antigen test results,they were devided into GBS antigen test positive 920 cases(infection group)and GBS antigen test negative 14280 cases(control group).Clinical data of patients was collected,the risk factors of GBS infection in pregnancy were analyzed by multiple logistic regression.Pregnancy outcome and maternal and child clinical outcome were tracked.Results The proportion of patients with age≥35 years old,history of abortion,vaginitis,gestational diabetes and vaginal microecology score(Nugent score)≥4 points in infection group were higher than those in control group(all P<0.05),and the proportion of undergraduates and above,living cities and participating in perinatal health care were lower than those in control group(all P<0.05).Multiple logistic regression analysis showed that age≥35 years old,history of abortion,vaginitis,gestational diabetes and Nugent score≥4 points were the high risk factors of GBS infection in pregnancy(OR=1.865,2.073,15.656,14.129,14.089,all P<0.05).The incidence of cesarean section,preterm delivery,low birth weight,GBS infection in newborn in infection group were higher than those in control group(P<0.05).Conclusion The infection rate of GBS in pregnancy is high.The high risk group of GBS infection is the elderly parturient,history of abortion,vaginitis,gestational diabetes and high Nugent score,who have high risk of adverse pregnancy outcome.