妊娠晚期B族链球菌感染对妊娠结局的影响

  目的 探讨妊娠晚期B族链球菌(group B streptococcus, GBS)感染对妊娠结局的影响。方法 选择2017-11至2018-03在医院就诊的1455例妊娠晚期孕妇作为研究对象,于孕35～37周行GBS检测,依据是否发生生殖道GBS感染分为GBS阳性组与GBS阴性组。GBS阳性组按接受治疗的方法不同,分为治疗A组(除常规产时或破膜后治疗外,于35-37周口服抗生素7 d)和治疗B组(常规产时或破膜后抗生素治疗)。比较治疗A、B两组间、GBS阳性组及GBS阴性组的妊娠结局。结果 (1)1455例孕妇中,GBS 阳性率为7.9% (115/1455);(2)GBS阳性组胎膜早破、早产、宫腔感染、剖宫产、羊水胎粪污染、产后出血、新生儿肺炎、新生儿感染的发生率均高于GBS阴性组孕妇,差异有统计学意义(P<0.05);(3)治疗A组与治疗B组所有观察指标比较,差异均无统计学意义。结论 妊娠期GBS感染更容易导致胎膜早破等不良妊娠结局的发生。为避免抗生素药物过度使用,应选择于临产或胎膜早破时对GBS带菌者进行预防性治疗,以达到满意的感染控制效果。

Effect of group B streptococcal infection on pregnancy outcomes in late pregnancy

Objective To investigate the effect of group B streptococcal infection on pregnancy outcome in late pregnancy.Methods The data of 1455 cases of pregnant women in our hospital were collected from 2017-11 to 2018-03.GBS test was performed at 35~37 weeks of pregnancy, it was divided into GBS positive group and GBS negative group according to whether that GBS infection occurred. The GBS positive group was divided into treatment group A (oral antibiotic 7 days at 35-37weeks,except for conventional treatment at birth or after premature rupture of membranes) and treatment group B (routine treatment at birth or after premature rupture of membranes) according to the different treatment methods.Pregnancy outcomes were compared between treatment groups A and B, GBS positive group and GBS negative group.Results (1)The positive rate of GBS was 7.9% (115/1455) in 1455 pregnant women;(2)The incidence rates of premature rupture of membranes, premature delivery, intrauterine infection, cesarean delivery, amniotic fluid turbidity, postpartum hemorrhage, pneumonia of newborn, and neonatal infections in the GBS positive group were statistically significantly higher than those in the GBS negative group (P<0.05); (3)There was no statistically significant difference between the treatment group A and the treatment group B in the all observation indicators.Conclusions GBS infection will easily result in premature rupture of membranes and other adverse pregnancy outcomes. In order to avoid overuse of antibiotics, prophylactic treatment for streptococcus B carriers should be carried out at the time of labor or premature rupture of membranes, so as to achieve satisfactory infection control effect.