妊娠晚期生殖道B族链球菌感染对母婴结局的影响因素分析

Influence factor analysis of genital tract group B streptococcus infection on maternal and infant outcomes during the third trimester of pregnancy

目的:探讨妊娠晚期生殖道B族链球菌感染对母婴结局的影响,分析影响感染的危险因素。方法:回顾性选择收集2016年10月-2018年10月本院收治的312例妊娠晚期孕妇,根据是否存在生殖道B族链球菌感染分为感染组(109例)和未感染组(203例)。观察两组临床资料和妊娠结局,分析生殖道B族链球菌感染的危险因素。结果:感染组早产、剖宫产、胎膜早破、宫内感染、产褥感染、产后出血发生率均高于未感染组,新生儿肺炎、窒息、宫内窘迫、病理性黄疸发生率和儿科转诊率均高于未感染组(P<0.05);logistic回归分析显示,孕妇年龄≥35岁(OR=1.253,P=0.023)、既往阴道炎史(OR=1.547,P=0.000)、流产史(OR=2.315,P=0.009)、文化程度低(OR=1.103,P=0.011)等是影响妊娠晚期生殖道B族链球菌感染的危险因素。结论:妊娠晚期生殖道B族链球菌感染可导致母婴妊娠结局不良,孕妇高龄、文化程度低、既往阴道炎史、流产史是导致生殖道B族链球菌感染的主要因素,产科应加强对孕产妇病原菌的检测及治疗。

Objective: To investigate the effect of genital tract group B streptococcus(GBS) infection on maternal and infant outcomes during the third trimester of pregnancy, and to analyze the risk factors of genital tract GBS infection. Methods: 312 pregnant women during the third trimester of pregnancy from October 2016 to October 2018 were selected retrospectively, and they were divided into group A(109 cases) and group B(203 cases) according to the status of genital tract GBS infection. The clinical data and pregnancy outcomes of women in the two groups were observed, and the risk factors of genital tract GBS infection were analyzed. Results: The incidences of premature delivery, cesarean section, premature rupture of membranes, intrauterine infection, puerperal infection, and postpartum hemorrhage, and the rates of neonatal pneumonia, asphyxia, intrauterine distress, pathological jaundice, and pediatric referral rate in group A were significant higher than those in group B(P<0.05). Logistic regression analysis showed that age equal to or more than 35 years old(OR=1.253,P=0.023), history of vaginitis(OR=1.547,P=0.000), history of abortion(OR=2.315, P=0.009), low educational level(OR=1.103, P=0.011) were risk factors of genital GBS infection during the third trimester of pregnancy. Conclusion: Genital tract GBS infection during the third trimester of pregnancy can lead to adverse pregnancy outcomes. Advanced age, low education level, past vaginitis and abortion history of pregnant women are the main factors affecting genital tract GBS infection, so the detection of maternal pathogenic bacteria infection, and intervention or treatment should be strengthen.