不同体质量指数孕妇B族溶血性链球菌定植状态及妊娠结局

Colonization status and pregnancy outcome of group B hemolytic streptococcus in pregnant women with different body mass indexes

目的探讨不同体质量指数(BMI)孕妇B族溶血性链球菌(GBS)定植状态及妊娠结局。方法选取2020年3月—2021年5月在舟山市妇女儿童医院进行定期产前检查并分娩的孕妇作为研究对象,共计248例,根据BMI不同,将其分为低重组、正常组、超重组和肥胖组,检测GBS定植状态,分析其与妊娠结局的关系。结果经GBS检测后,发现阳性24例,总阳性率为9.7%。低重组、正常组、超重组、肥胖组的GBS阳性率分别为8.0%、3.1%、17.3%、16.3%,组间比较差异有统计学意义(χ^(2)=10.910,P<0.05)。低重组、正常组、超重组、肥胖组剖宫产分别为9例(18.0%)、10例(10.3%)、34例(65.4%)、31例(63.3%),差异有统计学意义(P<0.05)。4组绒毛膜羊膜炎、产时发热、胎膜早破、低出生体质量儿、胎儿窘迫发生率比较差异均有统计学意义(均P<0.05)。GBS检测阳性的孕妇剖宫产率为58.3%,GBS检测阴性的孕妇剖宫产率为31.2%,差异具有统计学意义(P<0.05)。结论BMI过高和过低能够增加孕妇GBS定植率和不良妊娠结局。经过治疗后,GBS阳性孕妇的不良妊娠结局没有显著增加。

Objective To investigate colonization status and pregnancy outcome of group B hemolytic streptococcus(GBS)in pregnant women with different body mass indexes.Methods A toal of 248 pregnant women who underwent regular prenatal examination and delivered in Zhoushan Women and Children Hospital from March 2020 to May 2021 were selected as the research object.According to different body mass indexes,they were divided into low weight group,normal weight group,high weight group,and obesity group.The colonization status of GBS was detected,and the relationships with pregnancy outcomes were analyzed.Results After GBS detection,24 GBS-positive cases were detected,the total positive rate was 9.7%.GBS-positive rates in low weight group,normal weight group,high weight group,and obesity group were 8.0%,3.1%,17.3%,and 16.3%,respectively,there was statistically significant difference(χ^(2)=10.910,P<0.05).The rates of cesarean section in low weight group,normal weight group,high weight group,and obesity group were 18.0%(9 cases),10.3%(10 cases),65.4%(34 cases),and 63.3%(31 cases),respectively,there was statistically significant difference(P<0.05).There were statistically significant differences in the incidence rates of chorioamnionitis,intrapartum fever,premature rupture of fetal membranes,low birth weight infant,and fetal distress among the four geoups(P<0.05).The rates of cesarean section in GBS-positive and GBS-negative pregnant women were 58.3%and 31.2%,respectively,there was statistically significant difference(P<0.05).Conclusion Too high and too low body mass index can increase GBS colonization and adverse pregnancy outcomes of pregnant women.After treatment,the adverse pregnancy outcomes of GBS-positive pregnant women donot increase significantly.