围产期孕妇生殖道B族链球菌感染高危因素分析及母婴结局探讨  

High risk factors of group B Streptococcus infection in pregnant women during perinatal period and its effect on maternal and child outcomes

作　　者：王晓娜[1] 丛桂敏 冯小静[1] 杨静[1] 卓英梅[1] 李文杰[1] 曹作伟 佟成龙 武家淳 WANG Xiao-na;CONG Gui-min;FENG Xiao-jing;YANG Jing;ZHUO Ying-mei;LI Wen-jie;CAO Zuo-wei;TONG Cheng-long;WU Jia-chun(Department of Clinical Laboratory, Shenyang Women and Children Hospital, Shenyang 110014, Liaoning Province, China)

机构地区：[1]辽宁省沈阳市妇婴医院检验科,辽宁沈阳110014

出　　处：《微生物学免疫学进展》2019年第1期44-48,共5页Progress In Microbiology and Immunology

基　　金：辽宁省自然科学基金(20170540837)

摘　　要：目的调查沈阳地区围产期孕妇生殖道B族链球菌(group B streptococcus,GBS)定植率和感染高危因素及对母婴结局的影响,以便预防和控制围产期妇女GBS感染,优化母婴结局。方法对2017年9—11月在医院作孕期检查的31～40周孕晚期孕妇691例取阴道拭子及直肠拭子进行GBS培养、分离鉴定,分析GBS定植率;采用卡方检验进行GBS感染的单因素分析,采用多因素二元Logistic回归进行GBS感染的高危因素分析;对比两组孕妇及新生儿结局。结果沈阳地区孕晚期孕妇生殖道GBS定植率为7.67%(53/691),其中阴道试子阳性率为4.63%(32/691),直肠试子阳性率为6.22%(43/691);孕妇GBS感染的危险因素显示,在教育程度、生产史、分娩方式、甲状腺异常、妊娠期高血压、妊娠期贫血和妊娠期糖尿病,组间差异均无统计学意义(P>0.05);孕妇GBS感染危险因素,年龄、体质量、流产史和生殖道感染,组间比较,差异均有统计学意义(P<0.05);经多因素二元Logistic回归分析结果显示,年龄、体重、流产史和生殖道感染为影响GBS感染发生的独立危险因素,两组比较差异均有统计学意义(P<0.05);感染组孕妇胎膜早破、早产发生率高于对照组,经比较差异有统计学意义(P<0.05);产后出血发生率经比较差异无统计学意义(χ2=0.624,P>0.05);感染组新生儿胎儿窘迫、绒毛膜羊膜炎、新生儿黄疸发生率高于对照组,经比较差异有统计学意义(P<0.05)。结论沈阳市孕妇生殖道GBS定植率较高,建议对孕晚期孕妇开展GBS常规筛查。年龄、体重、流产史和生殖道感染为GBS感染发生的独立危险因素,有必要对本地区的围产期孕妇进行健康宣教,减少GBS感染的发生,进而改善母婴结局。Objective To investigate the colonization rate of B streptococcus in reproduction-tract,and the high risk factors of infection in perinatal pregnant women in Shenyang,in order to prevent and control perinatal women GBS(group B streptococcus) infection,and to improve the maternal and child outcomes.Methods Culture and isolation of GBS were conducted in 691 cases of pregnant women in the late stage for pregnancy of 31—40 weeks,who were examined in hospital from September to November 2017,and analysis of GBS colonazation.The chi-square test was used in analysis of a single factor,and multifactor binary logistic regression used high risk factors in GBS infection.Comparison was carried out the maternal and neonatal outcomes between two groups.Results The tested fertility rate,positive rate of vaginal examination,and positive rate of rectum examination were 7.67 %(53/691),4.63 %(32/691),and 6.22 %(43/691),respectively.Single factor analysis showed that there was no a statistical significance in the level of education,production history,delivery mode,thyroid abnormalities in gestational hypertension,anemia,and diabetes(all P > 0.05);and age,weight,history of abortion,and reproductive tract infection were protective factors for GBS infection during pregnancy.The difference is in statistically significant(all P<0.05);multi-factor logistic regression analysis showed that age,weight,history of abortion,and reproductive tract infection were independent risk factors for the occurrence of GBS infection(all P<0.05).Incidences of premature rupture of fetal membrane and premature delivery of pregnant women in the infection group were significantly higher than those in the control group,and the difference was in statistically significant(both P< 0.05).But there was no a statistical significance in postpartum hemorrhage(with χ2 value 0.624,P>0.05).Incidences of fetal distress,chorioamnionitis and neonatal jaundice in the infection group were significantly higher than those in the control group,The difference is in statistically

关 键 词：围产期 B族链球菌 危险因素 

分 类 号：R714.7[医药卫生—妇产科学]