孕晚期孕妇B族链球菌感染的分布特征、危险因素分析及对生殖道微生物和妊娠结局的影响

Characterization of the Distribution of Group B Streptococcal Infections in Pregnant Women in Late Pregnancy, Analysis of Risk Factors and Their Impact on Reproductive Tract Microbiology and Pregnancy Outcome

目的:分析孕晚期孕妇B族链球菌(GBS)感染特点、相关因素及对生殖道微生物和妊娠结局的影响。方法:回顾性分析982例2022年6月~2023年6月重庆市渝北区人民医院收治的孕晚期孕妇的临床资料,均接受阴道分泌物检查,根据GBS感染情况分为感染组(98例)和未感染组(884例)。予以单因素和Logistic回归分析孕晚期孕妇GBS感染的影响因素,并比较感染组和未感染组的生殖道微生物检出情况及妊娠结局。结果:两组年龄、体质量指数(BMI)、有无孕前检查、是否合并妊娠高血压、妊娠糖尿病、有无阴道与宫颈炎症比较有差异(P<0.05)。年龄≥35岁、BMI≥28 kg/m^(2)、合并妊娠高血压、妊娠糖尿病、有阴道与宫颈炎症是孕晚期孕妇GBS感染的独立危险因素(OR=2.477、3.077、4.586、3.540、2.942,P<0.05);孕前检查是保护因素(OR=0.465,P<0.05)。与未感染组比较,感染组滴虫、真菌、阴道病检出率及胎膜早破、胎儿宫内窘迫、新生儿肺炎、新生儿黄疸发生率更高(P<0.05)。结论:孕晚期孕妇GBS感染与年龄≥35岁、BMI≥28 kg/m^(2)、合并妊娠高血压、合并妊娠糖尿病、有阴道与宫颈炎症及孕前检查等有关,且GBS感染可影响生殖道微环境,引起不良妊娠结局的发生。

Objective: To analyze the characteristics of GBS infections in pregnant women in late pregnancy, associated factors,and their impact on reproductive tract microbiology, pregnancy outcomes. Methods: From June 2022 to June 2023, 982 late-pregnant pregnant women admitted to Yubei People's Hospital in Chongqing who received vaginal secretion examination, according to GBS infection, were divided into infected(98 cases) and uninfected(884 cases) groups. Factors influencing GBS infection in pregnant women in late pregnancy analyzed using univariate and Logistic regression, and the detection of genital tract microorganisms and pregnancy outcomes between the infected and uninfected groups were compared. Results: Age, body mass index(BMI), presence of preconception examination, presence of combined gestational hypertension, presence of combined gestational diabetes mellitus, and presence of vaginal and cervical inflammation were statistically different between the infected group and the uninfected group(P<0.05). Age ≥35 years,BMI ≥28 kg/m^(2), combined gestational hypertension, combined gestational diabetes mellitus, and the presence of vaginal and cervical inflammation were the independent risk factors(OR=2.477, 3.077, 4.586, 3.540, and 2.942, P<0.05);and that pre-pregnancy checkups were the protective factor(OR=0.465, P<0.05). The detection rates of trichomonas, fungi, vaginosis and the incidence of premature rupture of membranes, intrauterine distress, neonatal pneumonia, and neonatal jaundice were higher in the infected group when compared to the uninfected group(P<0.05). Conclusion: GBS infection in pregnant women in late pregnancy were associated with age ≥35 years, BMI≥28 kg/m^(2), comorbid gestational hypertension, comorbid gestational diabetes mellitus, presence of vaginal and cervical inflammation,and pre-pregnancy checkups, and GBS infection could affect the microenvironment of the reproductive tract and cause the development of adverse pregnancy outcomes.