Analysis in influencing factors of group B Streptococcus infection in late pregnancy
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摘要:目的 观察孕晚期孕妇的B族溶血性链球菌（GBS）感染情况并分析可能的危险因素。方法 选取接受正规产前GBS筛查的1 500例孕晚期孕妇作为观察对象，设计临床资料调查问卷，分析孕妇的临床资料，观察孕妇的GBS感染情况，采用单因素分析与多因素分析探讨诱发孕晚期GBS感染的危险因素。结果 1 500例孕晚期孕妇中，GBS阳性者225例，占15.00%；非感染组早产、低出生体质量儿、胎膜早破等不良妊娠结局的总发生率低于感染组，差异有统计学意义（P < 0.05）；多因素Logistic回归分析结果显示，孕前、孕早期、孕中期反复性阴道炎和妊娠期糖尿病、妊娠期高血压、孕期贫血、生活环境在农村、孕前体质量指数高均可能是导致孕晚期孕妇发生GBS感染的危险因素（OR>1，P < 0.05）。结论 孕晚期孕妇发生GBS感染可能受孕前、孕早期、孕中期阴道炎和妊娠期糖尿病、妊娠期高血压、孕期贫血等因素的影响。Abstract:Objective To observe the risk factors of group B Streptococcus (GBS) infection in late pregnancy, and to analyze the possible risk factors.Methods A total of 1 500 pregnant women in late pregnancy who received regular prenatal GBS screening were selected. The general situation questionnaire was designed, and the clinical data of pregnant women were recorded in details. The univariate and multivariate analysis were used to find out the influencing factors of GBS infection in late pregnancy.Results Among 1 500 pregnant women in late pregnancy, 225 cases of positive GBS were detected, accounting for 15.00%; the incidence of adverse outcomes such as premature birth, infant of low-birth weight, premature rupture of membranes in non-infection group was lower than that in the infection group (P < 0.05); multiple Logistic regression analysis showed that recurrent vaginitis in pre-pregnancy, early pregnancy and mid-pregnancy, gestational diabetes, gestational hypertension, gestational anemia, living environment in rural areas, high body mass index before pregnancy may be the influencing factors for GBS infection in late pregnancy (OR>1, P < 0.05).Conclusion GBS infection in late pregnancy is affected by recurrent vaginitis in pre-pregnancy, early pregnancy and mid-pregnancy, gestational diabetes, gestational hypertension, gestational anemia and other factors.
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Keywords:
- late pregnancy /
- group B Streptococcus /
- infection /
- recurrent vaginitis /
- risk factors
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表 1 2组孕妇一般资料比较(x±s)
组别 年龄/岁 孕次/次 产次/次 孕周/周 感染组(n=225) 28.12±3.61 3.11±0.56 2.11±0.65 35.89±1.22 非感染组(n=1 275) 28.54±3.21 3.12±0.63 2.13±0.58 36.02±1.20 
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表 2 2组不良妊娠结局比较[n(%)]
组别 早产 低出生体质量儿 胎膜早破 合计 感染组(n=225) 32(14.22) 23(10.22) 40(17.78) 95(42.22) 非感染组(n=1 275) 145(11.37) 110(8.63) 183(14.35) 438(34.35)* 与感染组比较, *P < 0.05。
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表 3 孕晚期GBS感染影响因素的单因素分析(x±s)[n(%)]
影响因素 感染组(n=225) 非感染组(n=1 275) χ2/t P 年龄 20~30岁 156(69.33) 884(69.33) < 0.001 1.000 31~40岁 69(30.67) 391(30.67) 孕前反复性阴道炎 有 161(71.56) 630(49.41) 37.624 < 0.001 无 64(28.44) 645(50.59) 孕早期、孕中期反复性阴道炎 有 168(74.67) 610(47.84) 55.119 < 0.001 无 57(25.33) 665(52.16) 妊娠期糖尿病 有 170(75.56) 606(47.53) 60.160 < 0.001 无 55(24.44) 669(52.47) 妊娠期高血压 是 158(70.22) 587(46.04) 44.741 < 0.001 否 67(29.78) 688(53.96) 孕期贫血 是 140(62.22) 456(35.76) 55.907 < 0.001 否 85(37.78) 819(64.24) 生活环境 农村 171(76.00) 523(41.02) 94.132 < 0.001 城市 54(24.00) 752(58.98) 孕前体质量指数 ≥30 kg/m2 121(53.78) 323(25.33) 74.256 < 0.001 < 30 kg/m2 104(46.22) 952(74.67) 职业 无业 85(37.78) 482(37.80) < 0.001 0.994 固定职业 140(62.22) 793(62.20) 受教育程度 初中及以下 75(33.33) 425(33.33) < 0.001 1.000 中专或高中 120(53.33) 680(53.33) 大专及以上 30(13.33) 170(13.33) 产次/次 2.11±1.12 2.13±1.15 0.241 0.809
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表 4 孕晚期GBS感染影响因素的多因素Logistic回归分析
危险因素 β SE Wald P OR 95%置信区间 孕前反复性阴道炎 0.946 0.158 35.838 < 0.001 2.576 1.890~3.511 孕早期、孕中期反复性阴道炎 1.167 0.163 51.144 < 0.001 3.213 2.333~4.424 妊娠期糖尿病 1.227 0.165 55.365 < 0.001 3.412 2.470~4.715 妊娠期高血压 1.017 0.156 42.341 < 0.001 2.764 2.035~3.754 孕期贫血 1.085 0.149 52.699 < 0.001 2.958 2.207~3.965 生活环境 1.565 0.166 88.934 < 0.001 4.783 3.455~6.622 孕前体质量指数 1.232 0.148 68.945 < 0.001 3.429 2.564~4.587
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