益生菌对妊娠晚期阴道B族链球菌定植、血清炎性因子及妊娠结局的影响

The effect of probiotics on the colonization of vaginal group B streptococcus,serum inflammatory factors and pregnancy outcome in the third trimester of pregnancy

目的观察口服益生菌对妊娠晚期阴道B族链球菌(GBS)感染孕妇阴道内GBS定植、血清炎性因子及妊娠结局的影响。方法选择2018年1月—2021年1月西南医科大学附属中医医院妇产科诊治的妊娠晚期GBS感染孕妇103例,按随机数字表法分为对照组51例和观察组52例。观察组孕妇口服益生菌直至分娩,并于分娩前4 h静脉滴注抗生素;对照组孕妇仅在分娩前4 h静脉滴注抗生素预防感染。比较2组孕妇治疗前后阴道GBS定量值、血清炎性因子水平,以及孕妇妊娠结局和新生儿结局的差异。结果治疗后,观察组阴道GBS定量值,血清白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平较治疗前降低,且观察组低于对照组(t/P=2.899/0.005、10.018/0.000、7.063/0.000、17.629/0.000)。对照组治疗后阴道GBS定量值,血清IL-6、CRP、TNF-α水平与治疗前比较差异无统计学意义(P>0.05)。观察组胎膜早破、早产、宫内感染、产褥感染、新生儿感染发生率低于对照组(χ^(2)/P=5.385/0.021、4.243/0.039、4.512/0.034、5.579/0.018、4.243/0.039)。结论口服益生菌可抑制妊娠晚期GBS定植,降低血清炎性因子水平和母婴围产期感染率,改善妊娠结局。

Objective To observe the effects of oral probiotics on vaginal GBS colonization,serum inflammatory factors and pregnancy outcome in pregnant women with vaginal group B streptococcus(GBS)infection in the third trimester of pregnancy.Methods From January 2018 to January 2021,103 pregnant women with GBS infection in late pregnancy diagnosed and treated by the Department of Obstetrics and Gynecology,Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,were divided into 51 cases in the control group and 52 cases in the observation group according to the random number table.The pregnant women in the observation group took probiotics orally until delivery,and received intravenous antibiotics 4 hours before delivery.Pregnant women in the control group received intravenous antibiotics only 4 hours before delivery to prevent infection.The quantitative value of vaginal GBS,serum inflammatory factor levels before and after treatment of the two groups of pregnant women,as well as the differences in pregnancy outcome and neonatal outcome of the pregnant women were compared.Results After treatment,the quantitative value of vaginal GBS in the observation group,serum interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-α(TNF-α)levels were lower than before treatment,and the observation group was lower than the control group(t/P=2.899/0.005,10.018/0.000,7.063/0.000,17.629/0.000).The quantitative value of vaginal GBS,serum IL-6,CRP,and TNF-αlevels in the control group after treatment were not significantly different from those before treatment(P>0.05).The incidence of premature rupture of membranes,premature delivery,intrauterine infection,puerperal infection,and neonatal infection in the observation group was lower than that in the control group(χ^(2)/P=5.385/0.021,4.243/0.039,4.512/0.034,5.579/0.018,4.243/0.039).Conclusion Oral probiotics can inhibit GBS colonization in late pregnancy,reduce serum inflammatory factor levels and perinatal infection rate of mother and infant,and improve pregnancy outcome.