Risk factors of group B streptococcus infection during pregnancy and the influence of pregnancy outcome
HE Wei1 DENG Yao2 LU Yu1
1.Department of Obstetrics and Gynecology, Women and Children′s Hospital Affiliated to Medical College of University of Electronic Science and Technology of China Chengdu Women′s and Children′s Central Hospital, Sichuan Province, Chengdu 610071, China;
2.Department of Laboratory, Women and Children′s Hospital Affiliated to Medical College of University of Electronic Science and Technology of China Chengdu Women′s and Children′s Central Hospital, Sichuan Province, Chengdu 610071, China
Abstract:Objective To explore the risk factors of group B streptococcus (GBS) infection during pregnancy and analyze the effect of GBS infection on pregnancy outcome. Methods From January 2018 to December 2019, 15 200 pregnant women who received treatment in Department of Obstetrics, Chengdu Women′s and Children′s Central Hospital were selected as the study objects. According to the antigen test results, they were devided into GBS antigen test positive 920 cases (infection group) and GBS antigen test negative 14 280 cases (control group). Clinical data of patients was collected, the risk factors of GBS infection in pregnancy were analyzed by multiple logistic regression. Pregnancy outcome and maternal and child clinical outcome were tracked. Results The proportion of patients with age ≥ 35 years old, history of abortion, vaginitis, gestational diabetes and vaginal microecology score (Nugent score) ≥ 4 points in infection group were higher than those in control group (all P < 0.05), and the proportion of undergraduates and above, living cities and participating in perinatal health care were lower than those in control group (all P < 0.05). Multiple logistic regression analysis showed that age ≥ 35 years old, history of abortion, vaginitis, gestational diabetes and Nugent score ≥ 4 points were the high risk factors of GBS infection in pregnancy (OR = 1.865, 2.073, 15.656, 14.129, 14.089, all P < 0.05). The incidence of cesarean section, preterm delivery, low birth weight, GBS infection in newborn in infection group were higher than those in control group (P < 0.05). Conclusion The infection rate of GBS in pregnancy is high. The high risk group of GBS infection is the elderly parturient, history of abortion, vaginitis, gestational diabetes and high Nugent score, who have high risk of adverse pregnancy outcome.
何伟1 邓耀2 卢彧1. 妊娠期B族溶血性链球菌感染的危险因素分析及妊娠结局的影响[J]. 中国医药导报, 2020, 17(23): 78-81.
HE Wei1 DENG Yao2 LU Yu1. Risk factors of group B streptococcus infection during pregnancy and the influence of pregnancy outcome. 中国医药导报, 2020, 17(23): 78-81.
[1] Raabe VN,Shane AL. Group B Streptococcus(Streptococcus agalactiae)[J]. Microbiol Spectr,2019,7(2):10.
[2] Vornhagen J,Adams Waldorf KM,Rajagopal L. Perinatal Group B Streptococcal Infections: Virulence Factors,Immunity,and Prevention Strategies [J]. Trends Microbiol,2017,25(11):919-931.
[3] Zhu Y,Huang J,Lin XZ,et al. Group B Streptococcus Colonization in Late Pregnancy and Invasive Infection in Neonates in China:A Population-Based 3-Year Study [J]. Neonatology,2019,115(4):301-309.
[4] Verani JR,McGee L,Schrag SJ,et al. Prevention of perinatal group B streptococcal disease-revised guidelines from CDC,2010 [J]. MMWR Recomm Rep,2010,59(RR-10):1-36.
[5] Le Doare K,O′Driscoll M,Turner K,et al. Intrapartum antibiotic chemoprophylaxis policies for the prevention of group b streptococcal disease worldwide: systematic review [J]. Clin Infect Dis,2017,65(suppl_2):S143-S151.
[6] 张月香,王建红,刘颖.Nugent计分法诊断细菌性阴道病的临床应用[J].现代检验医学杂志,2009,24(2):150-151.
[7] Madrid L,Seale AC,Kohli-Lynch M,et al. Infant group B streptococcal disease incidence and serotypes worldwide:systematic review and meta-analyses [J]. Clin Infect Dis,2017,65(suppl_2):S160-S172.
[8] 邱海凡,王剑平,王荣跃,等.妊娠晚期妇女B族链球菌感染危险因素分析[J].中国消毒学杂志,2018,35(4):283-285.
[9] 普筱敏,张力,旷凌寒,等.成都地区妊娠晚期B群链球菌定植情况调查及围产结局分析[J].现代妇产科进展,2018,27(1):33-36.
[10] 李金丽.胶体金免疫层析法快速检测B 族链球菌的临床评估[J].检验医学,2017,32(8):747-748.
[11] 张兰,朱樱梅,李敏许.妊娠期B 族链球菌感染的高危因素及其对新生儿预后影响分析[J].中国妇幼健康研究,2017,28(6):731-733.
[12] Carlsson I,Breding K,Larsson PG. Complications related to induced abortion: a combined retrospective and longitudinal follow-up study [J]. BMC Womens Health,2018, 18(1):158.
[13] Cools P,Melin P. Group B Streptococcus and perinatal mortality [J]. Res Microbiol,2017,168(9/10):793-801.
[14] Ohara N,Kaneko M,Nishibori T,et al. Fulminant type Ⅰ diabetes mellitus associated with Coxsackie virus type A2 infection:a case report and literature review [J]. Intern Med,2016,55(6):643-646.
[15] 曹清芸,柏明见,何美琳,等.B族链球菌在妊娠末期孕妇中的感染状态与阴道微生态评分相关性分析[J].现代检验医学杂志,2019,34(2):122-124.
[16] 杨梦楠,花晓琳,金敏菲,等.妊娠期B族链球菌感染现状及对母儿结局的影响[J].现代妇产科进展,2019,28(3):173-177.
[17] Furfaro LL,Chang BJ,Payne MS. Perinatal Streptococcus agalactiae Epidemiology and Surveillance Targets [J]. Clin Microbiol Rev,2018,31(4):e00049-18.
[18] Bianchi-Jassir F,Seale AC,Kohli-Lynch M,et al. Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide:Systematic Review and Meta-analyses [J]. Clin Infect Dis,2017,65(suppl_2):S133-S142.
[19] Surve MV,Anil A,Kamath KG,et al. Membrane Vesicles of Group B Streptococcus Disrupt Feto-Maternal Barrier Leading to Preterm Birth [J]. PLoS Pathog,2016,12(9):e1005816.
[20] Risso FM,Castagnola E,Bandettini R,et al. Group B Streptococcus late onset sepsis in very low birth weight newborns:10 years experience [J]. J Matern Fetal Neonatal Med,2018,31(1):18-20.
[21] 洪佳芬,苏玩琼,倪洁珊,等.妊娠期妇女B族链球菌感染情况分析及感染对母儿预后的影响[J].中外医学研究,2019,17(36):7-9.
[22] Burcham LR,Spencer BL,Keeler LR,et al. Determinants of Group B streptococcal virulence potential amongst vaginal clinical isolates from pregnant women [J]. PLoS One,2019,14(12):e0226699.