妊娠晚期B族链球菌感染对孕妇阴道清洁度及不良妊娠结局的影响

目的:探讨妊娠晚期阴道B族链球菌(group B Streptococcus,GBS)感染与阴道清洁度及不良妊娠结局的关系。方法:选择2012年6月至2014年8月在上海市嘉定区妇幼保健院产科检查及分娩的孕35周以上的孕妇共1 864例,常规进行阴道清洁度检测及GBS培养。比较阴道清洁度异常组与正常组孕妇GBS带菌率的情况。观察GBS(+)组与GBS(-)组孕妇胎膜早破、早产、产褥感染的发生情况。结果:1 864例中,GBS阳性率5.15%(96/1 864)。阴道清洁度正常孕妇1 057例,其中GBS阳性率3.60%(38/1 057);阴道清洁度异常孕妇807例,其中GBS阳性率7.19%(58/807),差异有统计学意义(P=0.001)。GBS感染孕妇胎膜早破与产褥感染的发生增加(P0.05),发生风险[比值比(odds ratio,OR)]分别增加13.40倍、2.20倍。结论:阴道清洁度异常者GBS带菌率更高;妊娠晚期GBS感染对围产期结局有不良影响,妊娠晚期应加强GBS检测。

Effect of Group B streptococcus on vaginal clearing degree and adverse pregnancy outcome

Objective:To investigate the group B streptococcus(GBS) conlonization rate in pregnant women. To discuss the relationship between vaginal colonization of GBS and vaginal clearing degree,and the adverse pregnancy outcome.Methods:1864 cases of pregnant women after 35 weeks taking regular prenatal and delivery in our hospital from June 2010 to August 2014 were investigated. The vaginal clearing degree and GBS was detected regularly. The GBS carrier rates were compared between the two groups of normal and abnormal vaginal clearing degree. The incidences of premature rupture of menbranes , premature delivery and puerperal infection were researched in GBS positive and negative groups.Results: In the 1864 cases of GBS were 5.15% (96/1864). Clearing degree of normal group, 1057 cases of pregnant women, with GBS positive rate 3.60% (38/1057); Clearing degree abnormal group, 807 cases of pregnant women, the GBS were 7.24% (58/807), two groups are statistically significant (P = 0.001).The incidence of premature rupture of membranes and puerperal infection of pregnant women were closely related with GBS infection (P <0.05),and the risk (odds ratio) increased by 13.40 times, 2.20 times,respectively. Conclusions: GBS carrier rate of pregnant women with abnormal vaginal cleaning degree was higher.The incidence of premature rupture of membranes and puerperal infection of pregnant women were closely related with GBS infection,which indicated that GBS infection in pregnant women with perinatal outcome had adverse effects.It suggests that GBS detection in the late pregnancy is necessary.