妊娠晚期孕妇生殖道B族链球菌带菌状况及其对妊娠结局和新生儿的影响

Bacteria carrying status of Group B Streptococcus in reproductive tract of pregnant women in third trimester and its influence on pregnancy and newborn outcome

目的分析妊娠晚期孕妇生殖道B族链球菌(GBS)带菌状况及其对妊娠结局、新生儿产生的不良影响。方法选择2021年5月—2022年5月在齐齐哈尔医学院附属第三医院接受产检并检出生殖道GBS感染的65例孕妇作为研究对象,纳入GBS组;另外选择同期在该院产检的65名健康孕妇作为对照组。比较两组一般资料,同时对孕妇感染生殖道感染GBS的危险因素进行分析,方法为多元Logistic回归分析法,比较两组的妊娠结局和新生儿结局。结果两组孕妇的年龄、孕周、产次、文化程度比较差异均无统计学意义。GBS组孕妇的产前检查次数明显少于对照组(次:5.23±1.22比8.54±1.25,P<0.05),流产史和阴道炎的发生率均明显高于对照组(流产史发生率:20.00%比4.62%,阴道炎发生率:21.54%比6.15%,均P<0.05)。Logistic回归分析显示,产前检查次数少[优势比(OR)为1.972,95%可信区间(95%CI)为1.276~3.198]、既往流产史(OR值为1.872,95%CI为1.121~3.198)、合并阴道炎(OR值为1.782,95%CI为1.321~3.241)均为孕妇感染GBS的独立危险因素。GBS组的不良妊娠结局发生率和新生儿不良结局发生率均明显高于对照组(不良妊娠结局发生率:16.92%比3.08%,新生儿不良结局发生率:18.46%比3.08%,均P<0.05)。结论孕妇生殖道GBS感染的危险因素主要为产前检查次数少、既往流产史、合并阴道炎,GBS感染可引发不良妊娠结局,并导致新生儿不良结局发生的风险增大,应积极检测并及时干预。

Objective To analyze the bacteria carrying status of Group B Streptococcus(GBS)in reproductive tract of pregnant women in the third trimester and its adverse effects on pregnancy and newborns outcome.Methods A total of 65 pregnant women with GBS infection in reproductive tract admitted in the Third Affiliated Hospital of Qiqihar Medical College from May 2021 to May 2022 were selected as research objects,and other 65 healthy pregnant women during the same period were selected as control group.General data of the two groups were compared,at the same time,the risk factors of pregnant women infected with GBS were analyzed by multiple Logistic regression analysis,and the pregnancy and neonatal outcome of the two groups were compared.Results There were no significant differences in age,gestational age,birth time and educational level between the two groups of pregnant women.The number of antenatal examinations in GBS group was significantly less than that in control group(times:5.23±1.22 vs.8.54±1.25,P<0.05),the abortion history and incidence of vaginitis were significantly higher than those in the control group(abortion history incidence:20.00%vs.4.62%,vaginitis incidence:21.54%vs.6.15%,both P<0.05).Logistic regression analysis found that the fewer prenatal examinations[odds ratio(OR)was 1.972,95%confidence interval(95%CI)was 1.276-3.198],previous abortion history(OR value was 1.872,95%CI was 1.121-3.198),and vaginitis(OR value was 1.782,95%CI was 1.321-3.241)were independent risk factors for GBS infection in pregnant women.The incidence of adverse pregnancy outcome and neonatal adverse outcome in GBS group were significantly higher than those in control group(incidence of adverse pregnancy outcome:16.92%vs.3.08%,incidence of neonatal adverse outcome:18.46%vs.3.08%,both P<0.05).Conclusions The risk factors of GBS infection in the reproductive tract of pregnant women mainly include fewer antenatal examinations,previous abortion history and vaginitis.GBS infection could lead to adverse pregnancy outcomes and increase the risk of neonatal outcomes,so it should be actively detected and timely intervention.