| 生殖道B族链球菌定植现状及妊娠结局分析 |
| 投稿时间：2017-06-20 修订日期：2017-07-07 点此下载全文 |
| 引用本文：郑建琼,陈海迎,陈晶晶,杨洁,凌思思,张红萍.生殖道B族链球菌定植现状及妊娠结局分析[J].医学研究杂志,2018,47(3):93-96,99 |
| DOI：
10.11969/j.issn.1673-548X.2018.03.024 |
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| 基金项目:浙江省温州市科技局基金资助项目（Y20150220） |
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| 中文摘要:目的 研究妊娠35~37周生殖道B族溶血性链球菌（group B streptococcus，GBS）定植对妊娠结局的影响。方法 选取2015年6月1日~2016年11月1日期间于温州市人民医院产前检查并住院分娩的单胎孕妇907例，于35~37孕周产前检查时或入院时取阴道下段1/3处及肛周分泌物进行GBS检测。比较采用实时聚合酶链反应（polymerase chain reaction，PCR）技术检测GBS定植阳性组与阴性组妊娠结局，并分析GBS定植与胎膜早破和高龄的关系。结果 GBS总体定植率为12.68%（115/792）。与GBS定植阴性组比较，GBS定植阳性组胎膜早破（26.56% vs 16.41%）、绒毛膜炎（34.78% vs 2.02%）、败血症（5.21% vs 0.25%）及新生儿肺炎（10.43% vs 1.01%）发生率均增加，差异有统计学意义（P<0.01）；GBS定植阳性组胎儿窘迫发生率（5.21% vs 2.52%）、新生儿黄疸（8.69% vs 8.33%）发生率均增加，差异有统计学意义（P<0.05）。Logistic回归分析结果表明GBS定植阳性是胎膜早破的危险因素（OR=2.16，95% CI：1.38~3.36，P<0.05）。年龄≥ 35岁的孕妇组GBS定植阳性率为15.62%（10/64），年龄<35岁的孕妇组GBS定植阳性率为12.46%（105/843），两组比较差异无统计学意义（χ2=0.54，P>0.05）。结论 妊娠35~37周生殖道GBS定植可导致不良妊娠结局，是胎膜早破的危险因素，有必要进行普遍筛查；高龄与生殖道GBS定值无关。 |
| 中文关键词:B族溶血性链球菌 实时聚合酶链反应 妊娠结局 |
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| Detection of Group B Streptococcus Colonization and the Effect on Maternal-neonatal Outcomes |
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| Abstract:Objective To study the influences of group B streptococcus (GBS) colonization in late pregnancies on pregnant outcomes. Methods A total of 907 pregnant women who received antenatal care and delivered in "Wenzhou People's Hospital" from June 1, 2015 to Nov 1, 2016 were enrolled in this study. Secretions from the lower third of the vagina and perianal area in the pregnant women at 35-37 weeks of gestation and tested for GBS colonization. Detection rate of the PCR DNA test was compared, and the relationship between GBS colonization and Premature rupture of membranes (PROM),maternal age. The statistical analysis methods included two independent samples t-test, Chi-square test and Logistic regression analysis. Results The detection rate of PCR DNA test was 12.68%(115/792). Compared with the pregnant women non-colonized with GBS, the rate of PROM (26.56% vs 16.41%), chorioamnionitis(34.78% vs 2.02%), neonatal sepsis(5.21% vs 0.25%) and neonatal pneumonia(10.43% vs 1.01%) were higher in the pregnant women colonized with GBS (P<0.01). Compared with the pregnant women non-colonized with GBS, the rate of fetal distress (5.21% vs 2.52%)and neonatal jaundice(8.69% vs 8.33%)were higher in the pregnant women colonized with GBS (P<0. 05). Logistic regression analysis showed that GBS colonization was a risk factor of PROM (OR=2.16,95%CI:1.38-3.36,P<0.05). The detection rate in pregnant women with age ≥ 35 years was 15.62%(10/64)and in pregnant women with age <35 years was 12.46% (105/843), respectively. No statistically significant differences were found between them. Conclusion GBS colonization in the pregnant women at 35-37 weeks of gestation was a risk factor of PROM and was associated with adverse pregnant outcomes. Advanced age has no correlation with GBS colonization. In a conclusion, it is necessary to adopt routine screening test for GBS colonization at 35-37 weeks of gestation. |
| keywords:Group B streptococcus Polymerase chain reaction Maternal-neonatal outcomes |
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