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目的分析妊娠晚期孕妇B族链球菌(GBS)的带菌情况、危险因素及对妊娠结局的影响。方法前瞻性分析2015年9月-2016年6月在该院就诊的妊娠晚期孕妇794例资料,采用聚合酶链反应(PCR)检测阴道和直肠分泌物标本,将GBS阳性111例纳入观察组,随机抽取同期产检检测GBS为阴性的111例纳入对照组。分析GBS带菌的高危因素及妊娠结局。结果(1)794例孕妇中,GBS阳性率为13.98%(111/794)。(2)两组年龄、孕次、孕周、产次、流产次数方面比较差异无统计学意义(P>0.05);对照组年龄≥35岁、经产妇、阴道炎及妊娠期糖尿病的比例显著低于观察组(P<0.05);多因素回归分析显示,年龄≥35岁、经产妇、阴道炎及妊娠期糖尿病为GBS带菌的危险因素。(3)两组早产、产后出血发生率比较差异无统计学意义(P>0.05);观察组胎膜早破、绒毛膜羊膜炎、新生儿感染发生率较对照组显著提高(P<0.05)。结论高龄、经产妇、阴道炎、妊娠期糖尿病为妊娠晚期孕妇GBS带菌的危险因素,妊娠晚期孕妇GBS带菌会增加胎膜早破、绒毛膜羊膜炎、新生儿感染等不良妊娠结局,故妊娠晚期对孕妇进行GBS筛查非常重要。
Objective To analyze the carrier status, risk factors and the effect on pregnant outcome of pregnant women with B streptococcus (GBS) in the third trimester of pregnancy. Methods Seven hundred and ninety-nine pregnant women of the third trimester of pregnancy were analyzed prospectively from September 2015 to June 2016. Vaginal and rectal secretions samples were collected by polymerase chain reaction (PCR). One hundred and eleven GBS positive patients were included in the observation group. One hundred and eleven cases with GBS negative at the same period were randomly selected into the control group. Analysis of high risk factors for GBS carriage and pregnancy outcomes. Results (1) Among 794 pregnant women, the positive rate of GBS was 13.98% (111/794). (2) There was no significant difference in age, gestational age, gestational age, parity and the number of miscarriage between the two groups (P> 0.05). The proportion of women with maternal, vaginal and gestational diabetes in the control group (P <0.05). Multivariate regression analysis showed that the risk of GBS-borne infection was more than 35 years old, and maternal, vaginitis and gestational diabetes mellitus were detected. (3) There was no significant difference in the incidence of preterm and postpartum hemorrhage between the two groups (P> 0.05). The incidence of premature rupture of membranes, chorioamnionitis and neonatal infection in observation group was significantly higher than that in control group (P <0.05) . Conclusion The elderly, maternal, vaginitis and gestational diabetes mellitus are the risk factors of GBS in pregnant women in the second trimester. GBS in pregnant women in the third trimester may increase the adverse pregnancy outcomes such as premature rupture of membranes, chorioamnionitis and neonatal infection. Therefore, GBS screening of pregnant women is very important.