孕晚期产妇生殖道B族链球菌感染与胎膜早破及新生儿结局的相关性

目的:探讨孕晚期产妇生殖道B族链球菌(group B Streptococcus,GBS)感染与胎膜早破及新生儿结局的相关性。方法:搜集2017年5月至2019年8月首都医科大学附属北京世纪坛医院产科门诊的2100例孕妇,选取其中122例孕晚期胎膜早破产妇作为观察组,另选取120例同期健康孕晚期产妇作为健康对照组,比较两组GBS感染率,依据观察组患者是否合并GBS感染,将其分为GBS阴性组与GBS阳性组,采用单因素和多因素logistic回归分析影响胎膜早破孕妇GBS感染的危险因素,观察不同组别不良妊娠情况及新生儿结局。结果:健康对照组GBS感染率显著低于观察组(P<0.05);两组孕妇胎位异常、双胎或多胎妊娠和巨大儿发生率比较差异具有统计学意义(P<0.05);经多因素logistic回归模型分析结果显示胎位异常、双胎或多胎妊娠和巨大儿为影响胎膜早破孕妇GBS感染的危险因素(P<0.05)。GBS阴性组早产、产后出血和宫内感染率均显著低于GBS阳性组(P<0.05);GBS阳性组新生儿窒息和新生儿肺炎感染发生率均高于GBS阴性组(P<0.05);两组新生儿感染率比较,差异无统计学意义(P>0.05)。结论:胎位异常、双胎或多胎妊娠和巨大儿均可影响孕晚期胎膜早破产妇GBS感染,GBS感染可致新生儿窒息、新生儿感染和新生儿肺炎的发生,同时引起早产、产后出血和宫内感染等不良妊娠结局的发生。临床需要对孕晚期产妇生殖道GBS感染进行及时监测和处理,以降低其不良母婴结局的发生率。

Correlations between group B Streptococcus infection of the genital tract of pregnant women in the third trimester and premature rupture of membranes and neonatal outcomes

Objective:To explore the correlations between group B Streptococcus(GBS)infection of the genital tract of pregnant women in the third trimester and premature rupture of membranes and neonatal outcomes.Methods:A total of 2100 pregnant women in obstetric clinics from May 2017 to August 2019 were collected.Among them,122 pregnant women with premature rupture of membranes in the third trimester were selected as an observation group,and 120 healthy pregnant women in the third trimester during the same period were selected as a healthy control group.GBS infection rates were compared between the 2 groups.According to whether the patients in the observation group were combined with GBS infection,they were divided into a GBS negative group and a GBS positive group.Single factor and multivariate logistic regression were used to analyze the risk factors of GBS infection in pregnant women with premature rupture of membranes,and to observe the adverse pregnancy conditions and neonatal outcomes in different groups.Results:The incidence of GBS infection in the healthy control group was lower than that in the observation group(P<0.05).There was a statistically significant difference in the incidence of abnormal fetal position,gemellary or multiple pregnancy and fetal macrosomia between the two groups(P<0.05).The results of multivariate logistic regression model analysis showed that abnormal fetal position,gemellary or multiple pregnancy and fetal macrosomia were the risk factors for GBS infection in pregnant women with premature rupture of membranes(P<0.05).The incidences of premature delivery,postpartum hemorrhage,and intrauterine infection in the GBS negative group were significantly lower than those in the GBS positive group(P<0.05).The incidences of neonatal asphyxia and neonatal pneumonia infection in the GBS positive group were higher than those in the GBS negative group(P<0.05).There was no significant difference in the incidence of neonatal infection between the 2 groups(P>0.05).Conclusion:Abnormal fetal position,gemellary or multiple pregnancy and fetal macrosomia can affect GBS infection in pregnant women with premature rupture of membranes in the third trimester.GBS infection can cause neonatal asphyxia,neonatal infection,and neonatal pneumonia,as well as adverse pregnancy outcomes such as premature birth,postpartum hemorrhage,and pneumonia infection,etc.In clinic,it is necessary to monitor and deal with the GBS infection of the genital tract of pregnant women in the third trimester in order to reduce the incidence of adverse maternal and infant outcomes.