妊娠晚期女性B族链球菌感染状态与阴道微生态及妊娠结局的相关性分析

目的探讨妊娠晚期女性B族链球菌(GBS)感染状态与阴道微生态及妊娠结局的相关性。方法选取2017年1月1日-2019年6月30日在某院分娩的妊娠晚期女性126例,检测统计GBS感染发生情况,比较GBS感染者与未感染者的临床特征、阴道微生态(Nugent)评分、妊娠结局,分析妊娠晚期女性GBS感染发生的影响因素、不同Nugent评分者GBS阳性率及GBS感染与妊娠结局的关联性。结果126例产妇47例发生GBS感染,感染率为37.3%,年龄、妊娠期糖尿病、妊娠期高血压、阴道炎、孕前检查、流产史是妊娠晚期GBS感染的独立影响因素;GBS感染者Nugent评分高于未感染者;Nugent评分>6分者GBS阳性率高于4~6分及≤3分者;GBS感染者剖宫产、胎膜早破、宫内感染、胎儿窘迫、新生儿窒息发生率高于未感染者;妊娠晚期GBS感染与Nugent评分呈正相关,与剖宫产、胎膜早破、宫内感染、胎儿窘迫、新生儿窒息发生率呈正相关。结论妊娠晚期GBS感染的发生受年龄、妊娠期并发症、阴道炎等多种因素影响,与阴道微生态紊乱密切相关,可增加不良妊娠结局发生风险,应及时给予有效治疗,以改善母婴健康。

Correlation between Infection Status of Group B Streptococcus and Vaginal Microecology and Pregnancy Outcome in Late Pregnancy

Objective To investigate the relationship between the infection status of group B streptococcus(GBS)in late pregnancy and vaginal microecology and pregnancy outcome.Methods A total of 126 females in the third trimester of pregnancy from January 1 st,2017 to June 30 th,2019 were enrolled in our hospital.The incidence of GBS infection was statistically analyzed.The clinical features,vaginal microecology(Nugent)score,pregnancy outcome and different Nugent of GBS infected and uninfected patients were compared.The positive rate of GBS in the scores was used to analyze the influencing factors of GBS infection in women with late pregnancy and the association between GBS infection and pregnancy outcome.Results Age,gestational diabetes,gestational hypertension,vaginitis,pre-pregnancy examination,and abortion history were independent factors influencing GBS infection in late pregnancy.The Nugent score of GBS infection was higher than that of uninfected patients;Nugent score>6 points GBS positive rate is higher than 4-6 points or≤3 points;GBS infected patients with cesarean section,premature rupture of membranes,intrauterine infection,fetal distress,neonatal asphyxia The rate was higher than that of uninfected patients;GBS infection was positively correlated with Nugent score in late pregnancy,and positively correlated with cesarean section,premature rupture of membranes,intrauterine infection,fetal distress and neonatal asphyxia.Conclusions The incidence of GBS infection in late pregnancy was affected by many factors such as age,gestational complications,vaginitis,etc.It was closely related to vaginal microecological disorders,which can increase the risk of adverse pregnancy outcomes.It should be given effective treatment in time to improve maternal and child health.