妊娠晚期B族链球菌感染孕妇分娩新生儿感染情况调查及影响因素分析  

Investigation and analysis of influencing factors of neonatal infection among pregnant women with GBS infection in late pregnancy

作　　者：杨珏 孙杨芳 YANG Jue;SUN Yang-fang(Hangzhou Hospital of Obstetrics and Gynecology,Hangzhou,Zhejiang 310000,China)

机构地区：[1]杭州市妇产科医院,浙江杭州310000

出　　处：《中国妇幼保健》2023年第15期2825-2828,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生科技计划(2020KY762)。

摘　　要：目的 调查妊娠晚期B族链球菌(GBS)感染孕妇分娩新生儿的感染情况,并分析其影响因素。方法 选取2020年4月—2021年6月杭州市妇产科医院200例妊娠晚期GBS感染孕妇为研究对象,均为单胎妊娠。调查妊娠晚期GBS感染孕妇分娩新生儿感染情况,并分析其影响因素。结果 200例妊娠晚期GBS感染孕妇分娩新生儿感染者占比为18.00%(36/200),年龄、户籍地、破膜时间、羊水胎粪污染及绒毛膜羊膜炎均与妊娠晚期GBS感染孕妇分娩新生儿感染相关(均P<0.05);年龄(OR=8.039,95%CI:6.542~9.878)、户籍地(OR=8.415,95%CI:5.741~12.335)、破膜时间(OR=15.810,95%CI:12.874~19.416)、羊水胎粪污染(OR=10.777,95%CI:9.415~12.336)及绒毛膜羊膜炎(OR=13.624,95%CI:11.825~15.697)均为妊娠晚期GBS感染孕妇分娩新生儿感染独立影响因素(P<0.05)。采用Hosmer-Lemeshow拟合优度检验显示,Chi-Square=9.789,DF=10,P=0.947,模型拟合效果较好;根据预测值和真实值绘制ROC曲线,AUC为0.919(95%CI:0.872~0.953),当Log(P)>3.57时,预测灵敏度为86.11%,特异度为93.29%。结论 妊娠晚期GBS感染孕妇分娩新生儿感染受年龄、户籍地、破膜时间、羊水胎粪污染及绒毛膜羊膜炎等多种因素影响,根据上述因素进行重点筛查有利于早期预防,改善妊娠结局。Objective To investigate the situation of neonatal infection of pregnant women with group B streptococcus(GBS) infection in late pregnancy,and to analyze its influencing factors.Methods A total of 200 pregnant women with GBS infection in the third trimester of pregnancy in our hospital from April 2020 to June 2021 were selected,all of them were singleton pregnancy.To investigate the infection status of neonates delivered by pregnant women with GBS infection in the third trimester of pregnancy,and analyze the influencing factors.Results The proportion of neonatal infections delivered by 200 pregnant women with GBS infection in late pregnancy was 18.00%(36/200),and age,domicile,time of rupture of membranes,amniotic fluid-fecal contamination and chorioamnionitis were associated with neonatal infections delivered by pregnant women with GBS infection in late pregnancy(P<0.05).Age(OR=8.039,95% CI:6.542-9.878),domicile(OR=8.415,95% CI:5.741-12.335),time of rupture of membranes(OR=15.810,95% CI:12.874-19.416),contamination with amniotic fluid and feces(OR=10.777,95% CI:9.415-12.336) and chorioamnionitis(OR=13.624,95% CI:11.825-15.697) were all independent factors influencing the delivery of newborns with GBS infection in late pregnancy(P<0.05).The Hosmer-Lemeshow goodness-of-fit test was used to show that Chi-Square=9.789,DF=10,P=0.947,and the model fit was good;the ROC curve was plotted based on the predicted and true values,and the AUC was 0.919(95% CI:0.872-0.953),and when Log(P) >3.57,the predictive sensitivity was 86.11% and specificity was 93.29%.Conclusion Neonatal infection in pregnant women delivering with GBS infection in late pregnancy is influenced by various factors such as age,domicile,time of rupture of membranes,amniotic fluid-fecal contamination and chorioamnionitis,etc.Focused screening based on these factors is beneficial for early prevention and improvement of pregnancy outcome.

关 键 词：B族链球菌 妊娠晚期 新生儿感染 绒毛膜羊膜炎 羊水胎粪污染 

分 类 号：R714[医药卫生—妇产科学]