围生期孕妇B族链球菌感染影响因素及产时预防性治疗对妊娠结局的影响分析

Analysis of influencing factors of group B hemolytic streptococcus infection in perinatal women and the influence of intrapartum preventive treatment on pregnancy outcome

目的分析围生期孕妇生殖道B族链球菌(group B hemolytic streptococcus,GBS)感染影响因素及产时抗生素预防性治疗(intrapartum antibiotic prophylaxis,IAP)对妊娠结局的影响,为优生优育提供理论依据。方法选取2018年6月至2020年6月在万宁市人民医院建档的妊娠晚期孕妇1850例,根据阴道分泌物GBS检测结果分为GBS阳性组和GBS阴性组,采用Logistic回归分析孕妇生殖道GBS感染影响因素。将GBS阳性者根据产妇意愿分为GBS阳性治疗组和GBS阳性未治疗组,对比三组入选者妊娠结局。结果①1850例孕妇中GBS阳性124例,GBS阳性率为6.70%。Logistic回归分析提示流产史、阴道炎、妊娠糖尿病是影响GBS感染的危险因素。②三组孕妇在产后盆腔炎、羊水污染、产后出血间比较差异无统计学意义(P>0.05);GBS阳性未治疗组早产率高于GBS阴性组(P<0.017),三组足月胎膜早破发生率两两比较差异均有统计学意义(P<0.017);三组新生儿出生体质量间比较差异无意义(P>0.05);三组新生儿Apgar评分两两比较差异均有意义(P<0.05);GBS阳性治疗组及GBS阳性未治疗组新生儿感染性肺炎发生率高于GBS阴性组,GBS阳性未治疗组新生儿败血症发生率高于GBS阴性组(P<0.017)。结论有流产史、阴道炎、妊娠糖尿病是影响围生期孕妇GBS感染的危险因素。IAP可有效改善GBS感染孕妇妊娠结局。

Objective To analyze the influencing factors of group B hemolytic streptococcus(GBS)infection in perinatal pregnant women and the effect of intrapartum antibiotic prophylaxis(IAP)on pregnancy outcome,so as to provide theoretical basis for eugenics.Methods 1850 pregnant women in late pregnancy who were established in Wanning people's Hospital from June 2018 to June 2020 were selected.According to the results of GBS detection of vaginal secretion,they were divided into GBS positive group and GBS negative group.The influencing factors of GBS infection in reproductive tract were analyzed by logistic regression.GBS positive patients were divided into GBS positive treatment group and GBS positive non treatment group according to the wishes of pregnant women.The pregnancy outcomes of the three groups were compared.Results①Among 1850 pregnant women,124 were GBS positive,and the positive rate of GBS was 6.70%.Logistic regression analysis showed that abortion history,vaginitis and gestational diabetes mellitus were risk factors for GBS infection.②There was no significant difference in postpartum pelvic inflammatory disease,amniotic fluid pollution and postpartum hemorrhage among the three groups of pregnant women(P>0.05);The preterm birth rate of GBS positive untreated group was higher than that of GBS negative group(P<0.017).There were significant differences in the incidence of premature rupture of membranes among the three groups(P<0.017).There was no significant difference in birth weight among the three groups(P>0.05);there was significant difference in Apgar score among the three groups(P<0.05);the incidence of neonatal infectious pneumonia in GBS positive treatment group and GBS positive untreated group was higher than that in GBS negative group,and the incidence of neonatal sepsis in GBS positive untreated group was higher than that in GBS negative group(P<0.017).Conclusion The risk factors of GBS infection in pregnant women during perinatal period are abortion history,vaginitis and gestational diabetes.IAP can effectively improve the pregnancy outcome of pregnant women infected with GBS.