分娩前4小时抗生素治疗对妊娠晚期B族链球菌筛查阳性孕妇围产结局的影响  

Impact of antibiotics treatment 4 hours before delivery on the perinatal outcomes of group B streptococcus screening positive puerperae in late pregnancy

作　　者：马瑶[1] 贾红梅[1] 陈斌[1] 陈磊[1] 刘海艳[1] 李贝[1] MA Yao;JIA Hongmei;CHEN Bin;CHEN Lei;LIU Haiyan;LI Bei(Department of Obstetrics,Haidian Maternal and Child Health Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀区妇幼保健院产科,北京100080

出　　处：《中国性科学》2020年第4期46-48,共3页Chinese Journal of Human Sexuality

摘　　要：目的了解妊娠晚期B族链球菌(group B streptococcus,GBS)阳性孕妇在分娩前4小时应用抗生素对围产结局的影响。方法选取2018年6月至2019年6月北京市海淀区妇幼保健院诊治的妊娠晚期顺产孕妇739例作为研究对象。其中GBS筛查阳性439例作为观察组,并根据是否在分娩前4小时应用抗生素,将观察组分为甲、乙两组,观察甲组(应用)312例,观察乙组(未应用)127例。再选取同时期妊娠晚期GBS筛查阴性的孕妇300例,作为对照组。比较观察甲、乙组和对照组的母儿结局。结果观察甲组、乙组和对照组胎儿窘迫、产后出血、早产的发生率比较,差异无统计学意义(P>0.05)。观察甲组胎膜早破率(8.7%)低于观察乙组(16.5%)、差异具有统计学意义(P<0.017),与对照组(8.7%)比较,差异无统计学意义(P>0.017)。观察甲组宫腔感染+产褥感染发生率低于乙组、略高于对照组,但差异无统计学意义(P>0.017);而观察乙组宫腔感染+产褥感染发生率高于对照组,差异具有统计学意义(P<0.017)。观察乙组新生儿感染及新生儿高胆红素血症的发生率明显高于观察甲组及对照组,差异具有统计学意义(P<0.017)。结论对于GBS筛查阳性的妊娠晚期孕妇,不仅需要预防性应用抗生素,还应尽可能在分娩前4小时以上应用,以改善围产结局。Objective To analyze the relationship between the use of antibiotics 4 hours before delivery and the perinatal outcomes of group B streptococcus(GBS) screening positive women in late pregnancy. Methods A total of 739 puerperae in late pregnancy received in Haidian Maternal and Child Health Hospital from June 2018 to September 2019 were selected including 439 GBS screening positive puerperae(observation group), and 300 GBS screening negative puerperae(control group). The observation group was further divided into group A(312 cases, with antibiotics administered 4 hours before delivery) and group B(127 puerpera, without antibiotics administered 4 hours before delivery). Maternal and infant outcomes were compared among group A, group B and control group. Results There was no statistically significant difference in the incidence of fetal distress, postpartum hemorrhage or premature delivery among group A, group B and control group(P>0.05). The incidence of premature rupture of membrane(PROM) was lower in group A(8.7%) than that in group B(16.5%), with statistically significant differences(P<0.017), but there was no statistically significant difference between group A and control group(8.7%). The rates of intrauterine infection and puerperal infection in group A were slightly lower than those in group B and higher than those in the control group, and there were no statistically significant differences(P>0.017). Meanwhile, the rates of intrauterine infection and puerperal infection in group B were higher than those in the control group, with statistically significant differences(both P<0.017). The incidences of neonatal infection and neonatal hyperbilirubinemia in group B were higher than those in group A and control group, both with statistically significant differences(P<0.017). Conclusions For GBS screening positive puerpera in late pregnancy, antibiotics should be used more than 4 hours before delivery to improve the perinatal outcomes.

关 键 词：B族链球菌 妊娠晚期 围产结局 

分 类 号：R714[医药卫生—妇产科学]