规范产时抗生素预防对合并无乳链球菌定植孕妇母婴结局的影响

Effects of standardized intrapartum antibiotic prophylaxis on maternal and infant outcomes in pregnant women with Streptococcus agalactiae colonization

目的探讨规范产时抗生素预防(IAP)对合并无乳链球菌[又称B族链球菌(GBS)]定植孕妇母婴结局的影响。方法回顾性分析2021年1月至2021年12月于福建省立医院南院产检并行阴道试产的176例GBS阳性孕妇的临床资料,均在临产或胎膜破裂后接受抗生素预防性治疗,根据抗生素使用的及时性、时长等情况将其分为IAP规范组(n=124)和IAP不规范组(n=52)。比较两组羊水污染、绒毛膜羊膜炎发生率,以及新生儿炎症指标、新生儿1分钟Apgar评分、出生体重和感染事件发生率。结果IAP规范组羊水浑浊、绒毛膜羊膜炎发生率与IAP不规范组比较差异无统计学意义(12.10%vs 17.31%,2.42%vs 1.92%;P>0.05)。IAP规范组新生儿入住NICU、新生儿肺炎、新生儿败血症的发生率,以及白细胞计数、中性粒细胞比低于IAP不规范组,差异有统计学意义(P<0.05)。结论规范的IAP能降低孕晚期合并GBS定植孕产妇的新生儿不良事件的发生率。

Objective To investigate the effects of standardized intrapartum antibiotic prophylaxis(IAP)on maternal and infant outcomes in pregnant women colonized with Streptococcus agalactiae[also known as group B streptococcus(GBS)].Methods The clinical data of 176 GBS-positive pregnant women who underwent obstetric examination and vaginal trial labor in Fujian Provincial Hospital South Branch from January 2021 to December 2021 were retrospectively analyzed.All of the pregnant women received antibiotic prophylaxis near the time of labor or after rupture of membranes.According to the timeliness and duration of antibiotic use,the pregnant women were divided into IAP standard group(n=124)and IAP non-standard group(n=52).The amniotic fluid contamination,the incidence of chorioamnionitis,as well as neonatal inflammatory indicators,neonatal 1-minute Apgar score,birth weight and incidence of infection events were compared between the two groups.Results There were no significant differences in the incidence of amniotic fluid turbidity and the incidence of chorioamnionitis between the IAP standard group and the IAP non-standard group(12.10%vs 17.31%,2.42%vs 1.92%;P>0.05).The incidence of the neonates admitted to neonatal intensive care unit(NICU),the incidence of neonatal pneumonia,the incidence of neonatal sepsis,white blood cell count and neutrophil ratio in the IAP standard group were lower than those in the IAP non-standard group,and the differences were statistically significant(P<0.05).Conclusion Standardized IAP can reduce the incidence of neonatal adverse events in pregnant women with GBS colonization in the third trimester.