湖南地区孕妇B族溶血性链球菌流行病学调查及危险因素分析

Epidemiological characteristics and risk factors of hemolytic streptococcus B in pregnant women in Hunan province

目的分析湖南地区孕妇B族溶血性链球菌流行病学及危险因素。方法选取湖南地区2019年1~6月做B族溶血性链球菌检测孕妇569例,采集阴道样本做B族溶血性链球菌培养,检测孕妇阳性率,分析孕妇B族溶血性链球菌流行病学及危险因素。结果569例孕妇中52例孕妇B族溶血性链球菌检测阳性,阳性率为9.14%(52/569)。不同年龄、民族孕妇B族溶血性链球菌阳性率比较,差异无统计学意义(P>0.05)。不同孕周、孕前体重指数(BMI)、生活区域、文化程度、产次、流产史、早产史、既往阴道疾病、妊娠期糖尿病、妊娠期高血压孕妇B族溶血性链球菌阳性率比较,差异有统计学意义(P<0.05)。孕周、孕前BMI、生活区域、文化程度、产次、流产史、早产史、既往阴道疾病、合并妊娠期糖尿病、合并妊娠期高血压为孕妇B族溶血性链球菌带菌的危险因素,其中孕周、孕前BMI、生活区域、文化程度、产次、流产史、既往阴道疾病为孕妇B族溶血性链球菌带菌的独立危险因素(P<0.05)。B族溶血性链球菌阳性孕妇剖宫产、羊水感染、宫内感染、新生儿感染、新生儿窘迫发生率均高于阴性孕妇,差异有统计学意义(P<0.05)。结论孕周、孕前BMI、生活区域、文化程度、产次、流产史、既往阴道疾病为湖南地区孕妇B族溶血性链球菌带菌的独立危险因素,阳性孕妇不良妊娠结局发生率较高,临床应根据B族溶血性链球菌带菌危险因素开展综合筛查及防控工作,以降低不良妊娠结局发生风险。

Objective To investigate the epidemiological characteristics and risk factors of hemolytic streptococcus B in pregnant women in Hunan province.Methods A total of 569 pregnant women who were examined for hemolytic streptococcus B in our hospital from January 2019 to June 2019 were enrolled in the study,who The vaginal specimens were collected for culture of group B hemolytic streptococci to detect the carrier rate of pregnant women,and to analyze the he epidemiological characteristics and risk factors of group B hemolytic streptococcus.Results Of the 569 pregnant women,52 cases were positive for group B hemolytic streptococcus,with positive rate being 9.14%(52/569).There were no significant differences in positive rates of group B hemolytic streptococcus in pregnant women with different ages and nationalities(P>0.05).However there were significant differences in positive rates of group B hemolytic streptococcus in pregnant women with different gestational weeks,pre pregnancy BMI,living area,education level,birth times,abortion history,premature birth history,previous vaginal diseases,gestational diabetes mellitus and gestational hypertension(P<0.05).The gestational weeks,BMI before pregnancy,living area,education level,birth time,abortion history,preterm birth history,previous vaginal disease,gestational diabetes mellitus,and pregnancy hypertension were risk factors for the infaction of B group hemolytic streptococci,in which,gestational age,BMI before pregnancy,living area,education level,birth time,abortion history,and previous vaginal diseases were independent risk factors(P<0.05).Moreover the incidence rates of cesarean section,amniotic fluid infection,intrauterine infection,neonatal infection and neonatal distress in pregnant women with positive group B hemolytic streptococcus were significantly higher than those in negative pregnant women(P<0.05).Conclusion The gestational weeks,BMI before pregnancy,living area,education level,birth times,abortion history,and previous vaginal diseases are independent risk factors of group B hemolytic streptococcus in pregnant women in Hunan province,and the incidence of adverse pregnancy outcomes of positive pregnant women is higher.Therefor it is necessary to perform comprehensive screening,prevention and control,so as to reduce the risk of incidence of adverse pregnancy outcomes.