Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2021, Vol. 17 ›› Issue (03): 347 -354. doi: 10.3877/cma.j.issn.1673-5250.2021.03.017

Original Article

Effect of group B Streptococcus infection in genital tract of pregnant women in third trimester on maternal and infant outcomes

Bei Dong, Sufang Zhou(), Xuan Zhang   

  • Received:2020-10-09 Revised:2021-05-07 Published:2021-06-01
  • Corresponding author: Sufang Zhou
  • Supported by:
    Maternal and Child Health Research Project of Jiangsu Province(F201668)
Objective

To explore influencing factors of group B Streptococcus (GBS) in genital tract of pregnant women in third trimester and its effects on outcomes of pregnant women and infants.

Methods

From August 2016 to August 2018, a total of 1 149 pregnant women in third trimester who received prenatal examination in People′s Hospital of Suzhou High-tech Zone and detection of GBS DNA by fluorescence quantitative PCR at gestational age of 35-37 weeks were selected as research subjects. By retrospective analysis method, they were divided into study group (n=81, GBS DNA+ in genital tract), and control group (n=1 068, GBS DNA- in genital tract). Measures of intrapartum antibiotic prophylaxis (IAP) was taken to subjects in study group. Clinical data of 2 groups such as age, educational background, gravidity, parity, history of abortion, mode of delivery, gestational age and body mass index (BMI) at delivery, serum vitamin D levels, rates of gestational diabetes mellitus (GDM), premature rupture of membranes, postpartum hemorrhage, and follow-up of GBS infection of neonates in study group at 4 weeks after birth were collected. Independent-samples t test, Mann-Whitney U test and chi-square test were used for statistical comparisons. Multivariate unconditional logistic regression analysis was used to analyze influencing factors of GBS infection in genital tract of pregnant women in third trimester. The procedure in this study was in line with the requirements of Helsinki Declaration of the World Medical Association revised in 2013, and has been approved by the Ethics Committee of People′s Hospital of Suzhou High-tech Zone (Approval No. 2016-001).

Results

①There were no statistically significant differences in composition ratio of primipara and multipara, history of abortion, incidence of GDM and serum vitamin D levels between two groups (P>0.05). While there were statistically significant differences in age, composition ratio of educational background and BMI at delivery between two groups (t=-2.004, P=0.045; χ2=69.972, P<0.001; t=7.054, P<0.001). ②Multivariate unconditional logistic regression analysis showed that BMI≥25 kg/m2 at delivery and high school education level or below were independent risk factors for GBS infection in genital tract of pregnant women in third trimester (OR=2.901, 6.137, 95%CI: 1.782-4.722, 3.737-10.078, all P<0.001). ③The incidence of puerperium infection and neonatal pneumonia in study group were 3.7% (3/81) and 4.9% (4/81), which were significantly higher than those in control group 0.8% (9/1 068) and 1.0% (11/1 068), respectively, and both differences were statistically significant (P=0.047; χ2=6.150, P=0.013). ④Among 81 neonates of study group, positive rate of GBS at 1 week after birth was 53.1% (43/81). The incidence of early onset GBS pneumonia in neonates was 2.5% (2/81).

Conclusions

BMI≥25 kg/m2 at delivery and high school education level or below are independent risk factors for GBS infection in genital tract of pregnant women in third trimester, and may lead to increased incidence of puerperium infection and neonatal pneumonia.

表1 晚孕期孕妇发生生殖道GBS感染影响因素的单因素分析
表2 晚孕期孕妇发生生殖道GBS感染影响因素的多因素非条件logistic回归分析变量的含义及其赋值情况
表3 晚孕期孕妇发生生殖道GBS感染影响因素的多因素非条件logistic回归分析
表4 2组孕妇及其分娩新生儿结局比较[例数(%)]
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