妊娠晚期孕妇B族链球菌定植发生母婴不良结局的临床情况分析

Clinical analysis of maternal and infant adverse outcomes with group B streptococcus colonization during the late pregnancy

目的探讨妊娠晚期孕妇B族链球菌(GBS)定植对妊娠结局的影响及相关性。方法选取2018年12月至2019年6月在浙江省余姚市人民医院进行产检并分娩的567例孕妇为研究对象,入组孕妇均取阴道下1/3处内阴分泌物进行GBS培养与筛查,依据GBS筛查结果,将入组孕妇分为GBS阴性组(8例)、GBS阳性组(559例)。比较两组孕妇一般情况及妊娠结局,并分析妊娠结局与GBS定植的相关性。结果两组孕妇年龄、孕周、产次、孕次、流产史、居住区域、民族比较差异无统计学意义(P>0.05)。GBS阳性组孕妇胎膜早破、胎儿窘迫发生率高于GBS阴性组[5/8比7.69%(43/559)、3/8比5.01%(28/559)],差异有统计学意义(P<0.05)。Spearman相关分析结果显示,孕妇GBS定植与胎膜早破、胎儿窘迫呈正相关(r=0.632、0.573,P<0.05)。结论妊娠晚期GBS定植与妊娠结局密切相关,加强GBS筛查,对降低不良妊娠结局具有重要意义。

Objective To investigatethe maternal and infant adverse outcomes of group B streptococcus(GBS)colonization during the late pregnancy.Methods A total of 567 pregnant women who underwent obstetrics and gynecology examination in Yuyao People′s Hospital from December 2018 to June 2019 were selected for the study.Internal vaginal secretions of all the pregnant women were extracted from the lower 1/3 of the vagina for bacterial culture,and GBS culture and screening were performed on pregnant women.According to the results of GBS screening,pregnant women were divided into GBS negative group(8 cases)and GBS positive group(559 cases).The general condition and pregnancy outcomes of pregnant women were compared between the two groups,and the correlation between pregnancy outcomes and streptococcus colonization was analyzed.Results There were no statistically significant differences in age,gestational weeks,number of births,number of pregnancies,history of abortion,residence area and ethnicity between the two groups(P>0.05).The incidence of premature rupture of membranes and fetal distress in GBS positive group were higher than those in GBS negative group:5/8 vs.7.69%(43/559),3/8 vs.5.01%(28/559),and the differences were statistically significant(P<0.05).Spearman single factor correlation analysis showed that GBS colonization in pregnant women were positively correlated with premature rupture of membranes and fetal distress(r=0.632,0.573,P<0.05).Conclusions GBS colonization in late pregnancy is closely related to pregnancy outcomes,and strengthening GBS screening has great significance to reduce adverse pregnancy outcomes.