孕晚期孕妇生殖道GBS感染及预防性治疗与妊娠结局和新生儿预后的关系  

Relationship between reproductive tract GBS infection and preventive treatment in late pregnancy and pregnancy outcome and neonatal prognosis

作　　者：胡毅娜[2] 周定杰 吴玉璘 杨月华 吕年青 庄咏梅 傅雅丽 HU Yina;ZHOU Dingjie;WU Yulin;YANG Yuehua;LYU Nianqing;ZHUANG Yongmei;FU Yali(Health Development and Research Center of Jiangsu Province/Adverse Reaction Monitoring Center of Family Planning Drugs,National Health Commission/Key Laboratory of Fertility Protection and Health Technology Evaluation of Jiangsu Province,Nanjing,Jiangsu 210036,China;Jiangxi Maternal and Child Health Hospital,Nanchang,Jiangxi 332000,China)

机构地区：[1]江苏省卫生健康发展研究中心/国家卫生健康委计划生育药具不良反应监测中心/江苏省生育力保护与卫生技术评估重点实验室,江苏南京210036 [2]江西省妇幼保健院,江西南昌332000

出　　处：《中国优生与遗传杂志》2023年第12期2472-2477,共6页Chinese Journal of Birth Health & Heredity

基　　金：江苏省科教能力提升工程(ZDXYS202210);江苏省医学科研项目(M2021092);江苏省卫生健康发展研究中心自主科研项目(JSHD2021061)。

摘　　要：目的探讨孕晚期孕妇生殖道B族链球菌(GBS)感染情况及预防性治疗对妊娠结局和新生儿预后的影响。方法选取2020年1月至2023年4月于江西省妇幼保健院就诊的500例待产孕妇,利用荧光聚合酶链反应(PCR)法检测500例孕晚期孕妇生殖道感染GBS情况,分为GBS阳性组(n=102)和GBS阴性组(n=398),收集其临床资料,分析孕晚期孕妇感染GBS的影响因素,并进行药物敏感(药敏)试验。根据是否接受预防性治疗将GBS阳性组孕妇分为研究组(接受预防性治疗,55例)和对照组(未接受预防性治疗,47例),比较两组孕妇妊娠结局和新生儿出生后情况。结果500例孕晚期孕妇GBS阳性率为20.4%(102/500)。孕早期体质量指数(BMI)≥25kg/m^(2)、经产、糖耐量异常、流产史和阴道与宫颈炎症为孕晚期孕妇感染GBS的独立危险因素(P<0.05)。GBS药敏试验结果显示,其对青霉素、头孢曲松、万古霉素、头孢噻肟、氨苄西林、苯唑西林、环丙沙星和利奈唑胺的敏感率较高(91.18%~100.00%),对红霉素的敏感度较低(38.24%)。研究组孕妇胎膜早破、产后出血、产褥感染、剖宫产、早产、无症状菌尿和羊膜腔感染发生率及新生儿感染、胎儿窘迫、窒息、胎儿生长受限、病理性黄痕、肺炎和败血症的发生率明显低于对照组孕妇(P<0.05)。结论孕晚期孕妇感染GBS的独立危险因素为孕早期BMI≥25 kg/m^(2)、经产、糖耐量异常、流产史和阴道与宫颈炎症。给予GBS阳性的孕晚期孕妇预防性治疗,对于孕妇的妊娠结局和新生儿出生后情况均有一定改善,可大大降低孕妇及新生儿不良妊娠结局风险。Objective To investigate the infection of group B streptococcus(GBS)in the reproductive tract of pregnant women in the third trimester of pregnancy and the effect of preventive treatment on pregnancy outcome and neonatal prognosis.Methods A total of 500 pregnant women from Jiangxi Maternal and Child Health Hospital from January 2020 to April 2023 were selected to detect GBS in 500 pregnant women in the third trimester of pregnancy by fluorescence polymerase chain reaction(PCR)method.According to the test results,they were divided into GBS positive group(102 cases)and GBS negative group(398 cases).Clinical data were collected to analyze the independent influencing factors of GBS infection in pregnant women in the third trimester,and drug sensitivity test was conducted.According to whether they received preventive treatment,pregnant women in GBS positive group were divided into study group(receiving preventive treatment,55 cases)and control group(not receiving preventive treatment,47 cases),and the pregnancy outcome and post-natal situation of pregnant women in the two groups were compared.Results The positive rate of GBS was 20.4%(102/500)in 500 late-pregnancy women.BMI≥25 kg/m^(2)in early pregnancy,abnormal glucose tolerance during childbirth,history of abortion and vaginal and cervical inflammation were independent risk factors for GBS infection in late pregnancy(P<0.05).The results of GBS drug sensitivity test showed that it was highly sensitive to penicillin,ceftriaxone,vancomycin,cefotaxime,ampicillin,benzacillin,ciprofloxacin and linezolid(91.18%–100.00%),but less sensitive to erythromycin(38.24%).The incidence rates of premature rupture of membranes,postpartum hemorrhage,puerperal infection,cesarean section,premature delivery,asymptomatic bacteriuria and amniotic cavity infection,neonatal infection,fetal distress,asphyxia,fetal growth restriction,pathological yellow marks,pneumonia and sepsis in the study group were significantly lower than those in the control group(P<0.05).Conclusion The independent r

关 键 词：孕晚期 B族链球菌感染 预防性治疗 妊娠结局 新生儿 

分 类 号：R714.2[医药卫生—妇产科学]