摘要
目的:分析孕晚期阴道微生态指标水平变化与B族链球菌(GBS)感染的关系及对分娩结局影响。方法:采用便利抽样法从本院自2022年4月-2024年4月收治的孕晚期孕妇中选取400例行GBS检测,比较GBS感染阳性(GBS阳性组)和阴性孕妇(GBS阴性组)阴道微生态指标,采用多因素logistic回归分析孕晚期GBS感染与阴道微生态改变的关系;根据阴道微生态检查结果将孕妇分为正常组、失衡组,比较两组分娩结局。结果:GBS阳性组过氧化氢(H_(2)O_(2))阳性率、pH值异常率、细菌性阴道病(BV)阳性率、阴道清洁异常率均高于GBS阴性组;Spearman分析显示,H_(2)O_(2)阳性率、pH值异常率、阴道清洁异常率、BV阳性率与孕晚期GBS感染呈正相关;多因素logistic回归分析显示,H_(2)O_(2)阳性、阴道清洁度异常、pH值异常、BV阳性均是孕晚期GBS感染的独立危险因素(均P<0.05)。阴道微生态失衡组胎膜早破、产后出血、产褥感染、胎儿宫内窘迫、新生儿感染发生率均高于正常组(P<0.05),剖宫产率、新生儿病理性高胆红素血症发生率两组未见差异(P>0.05)。结论:孕晚期阴道微生态改变与GBS感染、分娩结局密切相关,临床应高度重视H_(2)O_(2)阳性、阴道清洁度异常、高pH值、BV阳性的孕晚期孕妇,以减少不良分娩结局发生。
Objective:To analyze the correlation between the vaginal microecology indicators changes of pregnant women during the third trimester of pregnancy and their group B streptococcus(GBS)infection,and to study the impact of the changes of the vaginal microecology indicators of the women on their delivery outcomes.Methods:400 pregnant women during the third trimester of pregnancy who were admitted to the hospital from April 2022 to April 2024 were selected for GBS testing by convenience sampling.These women were divided into group A(women with GBS infection)and group B(women without GBS infection).The vaginal microecology indicators of the women were compared between the two groups.The correlation between the GBS infection of the women during the third trimester of pregnancy and their vaginal microecological changes was analyzed by multiple logistic regression analysis.According to the testing results of the vaginal microecology,these women were divided into group C(women with the normal vaginal microecology)and group D(women with the imbalance vaginal microecology),and the delivery outcomes of the women were compared between the two groups.Results:The positive rate of hydrogen peroxide(H_(2)O_(2)),the abnormal pH value,the positive rate of bacterial vaginosis(BV)and the abnormal vaginal cleaning rate of the women in group A were significantly higher than those of the women in group B.Spearman analysis showed that the rates of the positive H_(2)O_(2),abnormal pH value,abnormal vaginal cleaning and positive BV of the women were positively correlated with their GBS infection during the third trimester of pregnancy.Multivariate logistic regression analysis showed that the H_(2)O_(2) positive,the abnormal vaginal cleanliness,the abnormal pH value and the positive BV of the women were the independent risk factors of their GBS infection during the third trimester of pregnancy(all P<0.05).The incidences of the premature rupture of membranes,the postpartum hemorrhage,the puerperal infection,the fetal intrauterine distress and the neonatal infection of the women in group D were significantly higher than those of the women in group C(P<0.05),and there were no significant differences in the incidences of the cesarean section and the neonatal pathological hyperbilirubinemia of the women between the two groups(P>0.05).Conclusion:The vaginal microecological changes of the women in the third trimester of pregnancy are closely related to their GBS infection and delivery outcomes.The pregnant women with positive H_(2)O_(2),abnormal vaginal cleanliness,high pH value and positive BV during the third trimester of pregnancy should be paid attention to reduce the occurrence of their adverse delivery outcomes in clinic.
作者
赵春丽
张洁
刘炳霞
薛飞扬
ZHAO Chunli;ZHANG Jie;LIU Bingxia;XUE Feiyang(Jiaozhou Central Hospital,Qingdao,Shandong Province,266300)
出处
《中国计划生育学杂志》
2025年第6期1260-1265,共6页
Chinese Journal of Family Planning
基金
青岛市医疗卫生重点学科建设项目。
关键词
孕晚期
阴道微生态
B族链球菌
感染
不良分娩结局
相关性
The third trimester of pregnancy
Vaginal microecology
Group B Streptococcus
Infection
Adverse delivery outcome
Correlation
