妊娠晚期B族链球菌带菌状况分析及其对妊娠结局的影响  

Effect of perinatal group B streptococcus carriers in late pregnancy on pregnancy outcome

作　　者：孙丹华[1] 李宣[1] 杨翠芳[1] 王李利[1] 

机构地区：[1]河北港口集团有限公司港口医院妇产科,河北省秦皇岛市066000

出　　处：《中国综合临床》2014年第7期764-767,共4页Clinical Medicine of China

摘　　要：目的：探讨妊娠晚期 B 族链球菌（GBS）带菌状况以及 GBS 带菌对妊娠结局及围生儿的影响。方法选择妊娠35～37周孕妇520例，取产前阴道下1/3分泌物及肛周分泌物，分娩后胎盘子面和新生儿咽、耳泌物进行 GBS 检测。对带菌状况以及 GBS 带菌对妊娠结局及围生儿的影响进行分析。结果（1）520例孕妇 GBS 阳性检出率为10.19％（53/520）。（2）新生儿 GBS 带菌率为8.85％（46/520）。GBS 阳性母亲的新生儿带菌率（22.64％，12/53）高于阴性母亲（7.28％，34/467），差异有统计学意义（χ^2=13.928，P ＜0.05）。妊娠晚期 GBS 阳性者，其新生儿肺炎（20.75％，11/53）、上呼吸道感染（18.87％，10/53）发生率高于阴性者（8.57％，40/467；4.71％，22/467）。新生儿 GBS 阳性者的肺炎（21.73％，10/46）、上呼吸道感染（19.56％，9/46）发生率高于阴性者（8.65％，41/474；4.85％，23/474），差异有统计学意义（χ^2值分别为8.121、15.717，P 均＜0.05）。（3）妊娠晚期 GBS 阳性者胎儿窘迫、宫内感染发生率分别为47.17％（25/53）、15.09％（8/53），显著高于阴性者[分别为7.07％（33/467）、4.71％（22/467）]，差异均有统计学意义（χ^2值分别为77.248、9.440，P 均＜0.05）；而胎膜早破、早产发生率 GBS 阳性者分别为28.30％（15/53）、3.77％（2/53），与阴性者[分别为28.48％（133/467）、2.36％（11/467）]比较，差异无统计学意义（χ^2值分别为0.001、0.393，P 均＞0.05）。妊娠晚期 GBS 阳性者合并霉菌性阴道炎、前置胎盘比例[39.62％（21/53）、7.55％（4/53）]高于阴性者[20.56％（96/467）、1.93％（9/467）]，差异均有统计学意义（χ^2值分别为9.922、6.168，P 均＜0.05）。结论妊娠晚期 GBS 带菌明显增加宫内感染、胎儿窘迫及新生儿感染的发生率，对妊娠结局造成不良影响，应对孕妇常规行 GBS 筛检。Objective To investigate the group B streptococcus（ GBS）colonization rate and the relationship between vaginal colonization of GBS and the pregnancy outcome. Methods Five hundred and twenty cases pregnant women were selected as our subjects. Microbiological culture was used for culture of GBS in 1 / 3 of vagina and rectus before delivery,other samples from different sites after delivery（including neonatal throat,ear and placenta）. Results （1）The GBS carrier rate in 520 pregnant women was 10. 19%（53 / 520）. （2）GBS carrier rate in neonatal was 8. 85%（46 / 520）. The carrier rate of neonatal whose mothers also carried GBS was 22. 64%（12 / 53）,higher than that of non-carrier mothers（7. 28%（34 / 467）,χ^2 = 8. 192,P 〈 0. 05） . The rate of pneumonia and the upper respiratory tract infection of neonatal with GBS-carrier-mother were 20. 75%（11 / 53）and 18. 87%（10 / 53）,higher than that of non-carrier mothers（8. 57%（40 / 467）and 4. 71%（22 / 467））. The pneumonia rate and upper respiratory tract infection of GBS positive neonatal were 21. 73%（10 / 46）and 19. 56%（9 / 46）,higher than GBS negative one（8. 65%（41 / 474）;4. 85%（23 / 474））. and there were significant differences（χ^2 = 8. 121,15. 717;P 〈 0. 05）.（3）The incidence of intrauterine infection and fetal distress of neonatal with GBS（ ＋ ）mother were 47. 17%（25 / 53）,15. 09%（8 / 53）,significantly higher than that of negative（7. 07%（33 / 467）,4. 71%（22 / 467））,and the differences were statistically significant（ χ^2= 77. 248,9. 440;P 〈 0. 05）. But there were the similar incidence in term of premature rupture of fetal membranes,premature occurrence rate between GBS positive and negative mothers（ 28. 30%（ 15 / 53 ） vs. 28. 48%（133 / 467;3. 77%（2 / 53）vs. 2. 36%（11 / 467）;χ^2 = 0. 001,0. 393;P 〉 0. 05）. The rate of GBS positive with mycotic vaginitis,placenta previa ratio were 39. 62%（21 / 53）,7. 55%（4 / 53）,higher than that of GBS

关 键 词：妊娠晚期 B 族链球菌 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]