分析B族溶血链球菌感染对妊娠结局和胎膜早破产生的影响

Analysis of the impact of group B hemolytic streptococcus infection on pregnancy outcomes and premature rupture of membranes

目的研究B族溶血链球菌感染对妊娠结局和胎膜早破产生的影响。方法160例单胎妊娠产妇,按照B族溶血链球菌培养结果分成研究组(感染B族溶血链球菌,56例)及对照组(未感染B族溶血链球菌,104例)。分析B族溶血链球菌感染的影响因素,比较两组产妇的分娩方式、妊娠结局,新生儿结局。结果不同年龄、不同民族产妇的B族溶血链球菌感染阳性率比较,差异无统计学意义(P>0.05)。不同孕周、不同产次、有无流产史、是否合并妊娠期高血压及妊娠期糖尿病、有无既往阴道疾病史产妇的B族溶血链球菌感染阳性率比较,差异具有统计学意义(P<0.05)。多因素Logistic回归分析显示,孕周、产次、流产、既往阴道疾病是B族溶血链球菌感染的独立危险因素(OR=1.189、3.024、2.548、3.115,P<0.05)。研究组剖宫产率53.57%高于对照组的24.04%,阴道分娩率46.43%低于对照组的75.96%,差异具有统计学意义(P<0.05)。研究组产妇的胎膜早破发生率16.07%、宫内感染发生率23.21%、早产发生率16.07%高于对照组的2.88%、3.85%、3.85%,差异具有统计学意义(P<0.05);两组产妇的产后出血发生率比较,差异无统计学意义(P>0.05)。研究组胎儿窘迫发生率10.71%、新生儿窒息发生率8.93%、新生儿感染发生率16.07%均高于对照组的2.88%、1.92%、3.85%,差异具有统计学意义(P<0.05)。结论孕周、产次、流产、既往阴道疾病是B族溶血链球菌感染的独立危险因素,感染后对母婴安全均造成一定的危险,引发胎膜早破、新生儿窒息等危险事件发生。应做好预防工作,积极采取相应的措施,保障产妇及胎儿的安全,降低不良事件的发生。

Objective To study the impact of group B hemolytic streptococcus infection on pregnancy outcomes and premature rupture of membranes.Methods A total of 160 women with singleton pregnancies were divided into a study group(56 women infected with group B hemolytic streptococcus)and a control group(104 women not infected with group B hemolytic streptococcus)according to the culture results of group B hemolytic streptococcus.The factors influencing the infection of group B hemolytic streptococcus were analyzed,and the mode of delivery,pregnancy outcome and neonatal outcome of the two groups were compared.Results There was no statistically significant difference in the positive rate of group B hemolytic streptococcus infection among women of different ages and nationalities(P>0.05).The positive rates of group B hemolytic streptococcus infection in women with different gestational weeks,different number of deliveries,history of abortion,gestational hypertension and gestational diabetes mellitus,and history of vaginal disease were compared,and the differences were statistically significant(P<0.05).Multifactorial Logistic regression analysis showed that gestational weeks,number of deliveries,abortion,and history of vaginal disease were independent risk factors for group B hemolytic streptococcal infection(OR=1.189,3.024,2.548,3.115;P<0.05).The cesarean section rate of 53.57%in the study group was higher than that of 24.04%in the control group,and the vaginal delivery rate of 46.43%was lower than that of 75.96%in the control group.The differences were statistically significant(P<0.05).The incidence of premature rupture of membranes,intrauterine infection and preterm birth in the study group were 16.07%,23.21%and 16.07%,which were higher than those of 2.88%,3.85%and 3.85%in the control group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of postpartum hemorrhage between the two groups(P>0.05).The incidence of fetal distress,neonatal asphyxia and neonatal infection were 10.71%,8.93%and 16.07%in the study group,which were higher than those of 2.88%,1.92%and 3.85%in the control group,and the differences were statistically significant(P<0.05).Conclusion Gestational week,number of deliveries,abortion,and history of vaginal disease are independent risk factors for group B hemolytic streptococcus infection,which poses a certain risk to the safety of both mother and baby and triggers the occurrence of dangerous events such as premature rupture of membranes and neonatal asphyxia.Prevention should be done and appropriate measures should be actively taken to protect maternal and fetal safety and reduce the occurrence of adverse events.