妊娠晚期孕妇GBS感染对生殖道微生态的影响及与未足月胎膜早破的关系

Effect of GBS infection in late pregnancy on microecology of reproductive tract and its relationship with preterm premature rupture of membranes

目的 探讨妊娠晚期孕妇GBS感染对生殖道微生态的影响及与未足月胎膜早破(PPROM)的关系。方法 选取2019年1月至2022年2月于海南省妇女儿童医院产科进行住院分娩的PPROM产妇50例,纳入PPROM组;以1∶1比例随机抽取同期住院分娩的足月胎膜早破产妇50例为对照组。分别统计2组孕妇的相关临床病理资料,并对2组产妇实施PPROM单因素与多因素回归分析,构建分类树模型并对模型进行评价。分析生殖道微生态失衡与B族溶血性链球菌(GBS)感染的关系。结果 阴道微生态失衡、GBS感染均是PPROM发生的独立影响因素(P<0.05)。分类树模型对PPROM发生风险的预测效果较好。GBS感染阳性组妊娠晚期孕妇阴道清洁度Ⅲ~Ⅳ级占比、菌性阴道病占比、需氧性阴道炎占比、念珠菌性阴道炎占比、阴道pH>4.5占比均明显高于GBS感染阴性组,差异均有统计学意义(P<0.05)。结论 阴道微生态失衡、GBS感染均为PPROM发生的危险因素。妊娠晚期孕妇生殖道微生态失衡可能与GBS感染有关。分类树预测模型对妊娠晚期孕妇发生PPROM具有较高的预测效果。

Objective To investigate effect of GBS infection in late pregnancy on microecology of reproductive tract and its relationship with preterm premature rupture of membranes(PPROM).Methods A total of 50 parturients with PPROM who delivered in the obstetrics department of Hainan Women and Children’s Hospital from January 2019 to February 2022 were enrolled in the PPROM group,and 50 pregnant women with full-term premature rupture of membranes who were delivered in hospital at the same time at 1∶1 were randomly selected as the control group.The relevant clinicopathological data of the two groups of pregnant women were counted respectively,and PPROM univariate and multivariate regression analysis were performed on the two groups,and the classification tree model was constructed and evaluated.To analyze the relationship between reproductive tract microecological imbalance and GBS infection.Results Vaginal microecological imbalance and GBS infection were independent influencing factors of PPROM(P<0.05).The classification tree model was effective in predicting the occurrence risk of PPROM.The proportion of vaginal cleanliness gradeⅢ‒Ⅳ,bacterial vaginosis,aerobic vaginitis,candidal vaginitis and vaginal pH>4.5 in GBS positive group were significantly higher than those in GBS negative group(P<0.05).Conclusion Vaginal microecological imbalance and GBS infection are risk factors for PPROM.The imbalance of reproductive tract microecology in the third trimester of pregnancy may be related to GBS infection.The classification tree prediction model has a high prediction effect on the occurrence of PPROM in the third trimester of pregnancy.