孕晚期B族链球菌定植的危险因素及与不良妊娠结局的关系  

Risk factors of group B Streptococcus colonization in late pregnancy and its relationship with adverse pregnancy outcomes

作　　者：宦宇[1] 张宇雨 张春利 齐结华[1] 奚杰[2] 蔡徐山[1] HUAN Yu;ZHANG Yuyu;ZHANG Chunli;QI Jiehua;XI Jie;CAI Xushan(Department of Clinical Laboratory,Maternal and Child Health Hospital of Jiading District,Shanghai 201821,China;Department of Obstetrics,Maternal and Child Health Hospital of Jiading District,Shanghai 201821,China)

机构地区：[1]上海市嘉定区妇幼保健院检验科,上海201821 [2]上海市嘉定区妇幼保健院产科,上海201821

出　　处：《检验医学与临床》2022年第2期179-181,185,共4页Laboratory Medicine and Clinic

基　　金：上海市嘉定区第五批医学重点学科建设项目(2020-jdyxzdfcxk-03)。

摘　　要：目的探讨该院孕晚期孕妇B族链球菌(GBS)定植的危险因素及与不良妊娠结局的关系。方法选取2019年10月至2020年1月到该院就诊的439例孕晚期孕妇为研究对象。所有孕妇均取阴道及肛周分泌物标本进行实时荧光定量PCR检测GBS。采用多因素Logistic回归分析影响孕妇GBS定植的独立危险因素,并比较GBS阳性与阴性孕妇不良妊娠结局。结果与GBS阴性孕妇相比,GBS阳性孕妇有流产史人数比例、解脲支原体阳性率、真菌阳性率、唾液酸苷酶阳性率较高,白带清洁度Ⅲ~Ⅳ度所占比例较高,差异有统计学意义(P<0.05)。白带清洁度Ⅲ~Ⅳ度、唾液酸苷酶阳性、解脲支原体阳性、有流产史是影响孕晚期孕妇GBS定植的独立危险因素(P<0.05)。GBS阳性孕妇产程中发热、胎儿宫内窘迫、新生儿感染的发生率高于GBS阴性孕妇,差异有统计学意义(P<0.05)。结论影响该院孕晚期孕妇GBS定植的独立危险因素为有流产史、白带清洁度Ⅲ~Ⅳ度、唾液酸苷酶阳性、解脲支原体阳性,临床可针对上述因素加强对孕妇的健康宣教,有效预防孕妇GBS定植,改善母婴结局。Objective To explore the risk factors of group B Streptococcus(GBS) colonization and its relationship with adverse pregnancy outcomes of pregnant women in late pregnancy in the hospital.Methods A total of 439 pregnant women in late pregnancy who visited the hospital from October 2019 to January 2020 were selected as the research objects.All pregnant women took samples of vaginal and perianal secretions for real-time fluorescent quantitative PCR to detect GBS.Multivariate Logistic regression analysis was used to analyze the independent risk factors affecting GBS colonization in pregnant women, and the adverse pregnancy outcomes of GBS positive and negative pregnant women were compared.Results Compared with GBS negative pregnant women, the proportion of pregnant women with a history of miscarriage, the positive rate of Ureaplasma urealyticum, the positive rate of mold, the positive rate of sialidase, and the proportion of leucorrhea cleanliness Ⅲ-Ⅳ degree in GBS positive pregnant women were higher, and the differences were statistically significant(P<0.05).The leucorrhea cleanliness Ⅲ-Ⅳ degree, sialidase positive, Ureaplasma urealyticum positive, and a history of miscarriage were independent risk factors affecting GBS colonization of pregnant women in late pregnancy(P<0.05).The incidence of fever during labor, fetal distress, and neonatal infection in GBS positive pregnant women was higher than those in GBS negative pregnant women, and the differences were statistically significant(P<0.05).Conclusion The leucorrhea cleanliness Ⅲ-Ⅳ degree, sialidase positive, Ureaplasma urealyticum positive, and a history of miscarriage are independent risk factors affecting GBS colonization of pregnant women in late pregnancy in the hospital.The clinic could strengthen the health education of pregnant women in response to the above factors, effectively prevent the colonization of GBS in pregnant women, and improve the maternal and infant outcomes.

关 键 词：B族链球菌 不良妊娠结局 孕妇 孕晚期 

分 类 号：R446.5[医药卫生—诊断学]