围产期B族链球菌感染筛查和敏感抗生素治疗对妊娠结局的影响

Influence of perinatal screening of group B streptococcus infection and sensitive antibiotic treatment on pregnancy outcomes

目的:探讨围产期B族链球菌(group B streptococcus,GBS)感染筛查和敏感抗生素治疗对妊娠结局的影响。方法:选取2018年3月至2020年10月在青岛市胶州中心医院产科接受围产期GBS筛查且结果为阳性的130例孕妇(孕35~37周),记为阳性组。阳性组按治疗方法不同分为A组和B组,A组于临产后或胎膜早破时给予敏感抗生素治疗;B组明确感染后即给予敏感抗生素口服7 d,临产后或胎膜早破时给予敏感抗生素治疗。另选取120例正常围产期孕妇作为阴性对照,记为阴性组。统计入选孕妇和新生儿妊娠结局,并进行组间比较。结果:GBS对青霉素G、头孢噻肟、万古霉素和氨苄西林敏感。与阴性组比较,阳性组早产、胎膜早破、产褥感染、胎儿窘迫、黄疸、宫内感染和新生儿肺炎发生率均较高,差异均有统计学意义(均P<0.05)。A组和B组上述妊娠结局发生率比较,差异无统计学意义(P>0.05)。结论:GBS感染增加不良妊娠结局风险,需重视围产期GBS筛查和GBS感染者的预防性治疗,临产或胎膜早破时是理想的治疗时机。

Objective:To explore the influence of perinatal group B streptococcus(GBS) infection screening and sensitive antibiotic treatment on pregnancy outcomes.Methods:A total of 130 pregnant women(35–37 weeks of gestation) who received perinatal GBS screening in our hospital from March 2018 to October 2020 were selected as a positive group.The positive group was divided into group A and group B according to different treatment methods.Group A was given sensitive antibiotics after labor or premature rupture of membranes.Group B was given sensitive antibiotics orally for 7 days after infection,and sensitive antibiotics were given after labor or premature rupture of membranes.Another 120 cases of normal perinatal pregnant women were selected as a negative group.The pregnancy outcomes of pregnant women and newborns were analyzed.Results:GBS was sensitive to penicillin G,cefotaxime,vancomycin,and ampicillin.Compared with the negative group,the positive group had higher incidence of preterm birth,premature rupture of membranes,puerperal infection,fetal distress,jaundice,intrauterine infection,and neonatal pneumonia,the difference was statistically significant(P<0.05).There was no significant difference in the incidence of pregnancy outcomes between group A and group B(P>0.05).Conclusion:GBS infection increases the risk of adverse pregnancy outcomes.It is necessary to pay attention to perinatal GBS screening and preventive treatment of GBS infected patients.The ideal time for treatment is after labor or premature rupture of membranes.