妊娠晚期女性B族链球菌感染特征及对妊娠结局的影响分析

The characteristics of group B streptococcal infection in women in the third trimester of pregnancy and its impact on pregnancy outcome

目的分析B族链球菌(GBS)感染妊娠晚期女性的感染特征及对妊娠结局的影响。方法150例妊娠晚期女性作为研究对象,均接受GBS感染检测,根据检测结果将其划分为对照组(未感染GBS,100例)及观察组(感染GBS,50例)。比较两组临床资料、阴道微生态评价标准(Nugent评分)情况、妊娠结局、新生儿健康情况。结果在150例妊娠晚期女性中,GBS感染50例、未感染100例,感染率为33.33%。观察组年龄>35岁占比40.00%、出现妊娠期糖尿病占比40.00%、出现妊娠期高血压占比40.00%、出现阴道炎占比24.00%、有流产史占比30.00%均高于对照组的19.00%、20.00%、15.00%、8.00%、10.00%,做过产前检查占比76.00%低于对照组的92.00%,差异具有统计学意义(P<0.05);两组经产情况、文化程度比较,差异无统计学意义(P>0.05)。观察组的Nugent评分为(4.68±0.44)分,高于对照组的(3.95±0.52)分,差异具有统计学意义(t=8.515,P=0.000<0.05)。观察组的Nugent评分情况差于对照组,差异具有统计学意义(P<0.05)。观察组剖宫产、胎膜早破、宫内感染、胎儿窘迫、新生儿窒息发生率分别为22.00%、30.00%、14.00%、8.00%、14.00%,均高于对照组的8.00%、9.00%、2.00%、1.00%、1.00%,差异具有统计学意义(P<0.05)。观察组新生儿的血气pH值为(7.51±0.21),低于对照组新生儿的(7.91±0.44),差异具有统计学意义(t=6.084,P=0.000<0.05)。观察组新生儿的1 min Apgar评分为(8.01±0.22)分,低于对照组新生儿的(8.81±0.43)分,差异具有统计学意义(t=12.357,P=0.000<0.05)。观察组新生儿的血气pH值<7.2占比、1 min Apgar评分<7分占比均高于对照组新生儿,差异具有统计学意义(P<0.05)。结论GBS感染的妊娠晚期女性感染特征为年龄>35岁,出现妊娠期糖尿病、妊娠期高血压、阴道炎、有流产史等,其发生剖宫产、胎膜早破、宫内感染、胎儿窘迫、新生儿窒息等妊娠结局的几率均比未感染者高。

Objective To explore the characteristics of group B streptococcus(GBS)infection in women in the third trimester of pregnancy and its impact on pregnancy outcome.Methods A total of 150 women in the third trimester of pregnancy were selected as study subjects,all of whom were tested for GBS infection and divided into a control group(no GBS infection,100 cases)and an observation group(GBS infection,50 cases)according to the test results.The clinical data,Nugent score,pregnancy outcomes and neonatal health were compared between the two groups.Results Among 150 women in the third trimester of pregnancy,50 cases were infected with GBS and 100 cases were not infected,with an infection rate of 33.33%.In the observation group,40.00%aged>35 years,40.00%had gestational diabetes,40.00%had gestational hypertension,24.00%had vaginitis,and 30.00%had a history of miscarriage,which were higher than those of 19.00%,20.00%,15.00%,8.00%and 10.00%in the control group;the percentage of prenatal checkups was 76.00%in the observation group,which was lower than that of 92.00%in the control group;the differences were statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of multiparity and level of education(P>0.05).The Nugent score of(4.68±0.44)points in the observation group was higher than that of(3.95±0.52)points in the control group,and the difference was statistically significant(t=8.515,P=0.000<0.05).The Nugent score of the observation group was worse than that of the control group,and the difference was statistically significant(P<0.05).The incidence rates of cesarean section,premature rupture of membranes,intrauterine infection,fetal distress and neonatal asphyxia were 22.00%,30.00%,14.00%,8.00%and 14.00%in the observation group,which were higher than those of 8.00%,9.00%,2.00%,1.00%and 1.00%in the control group,and the differences were statistically significant(P<0.05).The blood gas pH of neonates was(7.51±0.21)in the observation group,which was lower than that of(7.91±0.44)in the control group,and the difference was statistically significant(t=6.084,P=0.000<0.05).The 1 min Apgar score of neonates was(8.01±0.22)in the observation group,which was lower than that of(8.81±0.43)in the control group,and the difference was statistically significant(t=12.357,P=0.000<0.05).The percentage of blood gas pH<7.2 and the percentage of 1 min Apgar score<7 points in the observation group were higher than those in the control group,and the differences werestatistically significant(P<0.05).Conclusion Women with GBS infection in the third trimester of pregnancy are characterized by over 35 years of age,diabetes mellitus in pregnancy,pregnancy induced hypertension,vaginitis,history of abortion.The probability of cesarean section,premature rupture of membranes,intrauterine infection,fetal distress and neonatal asphyxia in GBS infected patients is higher than that in non-infected patients.