妊娠晚期孕妇血清hs-CRP水平、GBS感染对妊娠及新生儿结局的影响

The influence of serum hs CRP levels and GBS infection in late pregnancy women on pregnancy and neonatal outcomes

目的:分析妊娠晚期孕妇血清超敏C反应蛋白(hs-CRP)水平、生殖道B族链球菌(GBS)感染与妊娠及新生儿结局的关系。方法:采用回顾性分析,将2022年1月至2022年10月在本院诊治的90例妊娠晚期孕妇作为研究对象,根据是否出现胎膜早破进行分组,即将出现胎膜早破的41例妊娠晚期孕妇设为观察组,将未出现胎膜早破的49例妊娠晚期孕妇设为对照组。于孕晚期未出现胎膜早破前检测血清hs-CRP水平,采集两组妊娠晚期孕妇生殖道分泌物进行细菌培养,检测GBS感染情况、GBS病原菌数量,并在新生儿娩出后采集鼻咽拭子标本检测GBS阳性率。比较两组孕妇血清hs-CRP水平、GBS感染情况预测胎膜早破的临床意义,并对比分析血清hs-CRP、GBS感染对胎膜早破孕妇结局、新生儿结局的影响。结果:观察组血清hs-CRP阳性率、GBS阳性率高于对照组(P<0.05);观察组Hs-CRP水平、GBS病原菌数量高于对照组(P<0.05);联合血清hs-CRP水平、GBS病原菌数量诊断胎膜早破灵敏度、特异度高于单一检测诊断价值;血清hs-CRP阳性者剖宫产率、早产率高于阴性者(P<0.05),GBS感染阳性者的剖宫产率、宫内感染率、早产率、新生儿窒息率、新生儿宫内感染率高于阴性者(P<0.05)。结论:妊娠晚期孕妇生殖道GBS感染可诱发胎膜早破,增加新生儿感染概率,且母婴围生不良结局发生风险较高。

Objective:To analyze the relationship between serum levels of hypersensitive C-reactive protein(hs CRP),infection with Group B streptococci(GBS)in the reproductive tract,and pregnancy and neonatal outcomes in late pregnancy women.Methods:A retrospective analysis was conducted on 90 late pregnancy pregnant women who were diagnosed and treated in our hospital from January 2022 to October 2022.They were divided into groups based on the presence or absence of premature rupture of membranes.41 late pregnancy pregnant women who were about to experience premature rupture of membranes were assigned to the observation group,and 49 late pregnancy pregnant women who did not experience premature rupture of membranes were assigned to the control group.Before the occurrence of premature rupture of membranes in late pregnancy,serum hs CRP levels were measured.Two sets of reproductive tract secretions from late pregnancy women were collected for bacterial culture to detect GBS infection and the number of GBS pathogens.Nasopharyngeal swab samples were collected after neonatal delivery to detect the positive rate of GBS.Compare the clinical significance of serum hs CRP levels and GBS infection in predicting premature rupture of membranes between two groups of pregnant women,and compare and analyze the impact of serum hs CRP and GBS infection on the outcomes of pregnant women and newborns with premature rupture of membranes.Result:The positive rates of hs CRP and GBS in the observation group were higher than those in the control group(P<0.05);The levels of Hs-CRP and the number of GBS pathogens in the observation group were higher than those in the control group(P<0.05);The sensitivity and specificity of combining serum hs CRP levels and the number of GBS pathogens in diagnosing premature rupture of membranes are higher than the diagnostic value of a single test;The cesarean section rate and premature birth rate of serum hs CRP positive individuals were higher than those of negative individuals(P<0.05).The cesarean section rate,intrauterine infection rate,premature birth rate,neonatal asphyxia rate,and intrauterine infection rate of GBS positive individuals were higher than those of negative individuals(P<0.05).Conclusion:GBS infection in the reproductive tract of late pregnancy pregnant women can induce premature rupture of membranes,increase the probability of neonatal infection,and have a higher risk of adverse perinatal outcomes.