- 期刊
- OpenAccess
孕婦B族鏈球菌感染與新生兒預後相關性的回顧性分析
Retrospective analysis of neonatal outcomes in maternal group B streptococcus infection
摘要
目的：以澳門地區孕婦為研究對象，探討B族鏈球菌感染發病率，分娩方式與新生兒預後相關關係。方法：採用2012年在本院分娩並在孕晚期感染GBS者171人為研究對象，於孕35～37週留取孕婦生殖道分泌物行細菌培養；所有入選病例生產的新生兒均行耳、咽、鼻拭子細菌培養，以體溫，胸片，CBC，CRP，NE%作為新生兒感染的觀察指標，同時採集孕婦的臨床特徵（包括孕週，胎次，年齡，分娩方式，破膜方式，羊水性狀等），進行卡方分析。結果：陰道分娩及剖宮產分娩新生兒耳培養B族鏈球菌陽性率有差異（P<0.05），陰道分娩新生兒陽性率高於剖宮產新生兒，新生兒血白細胞總數間有差異（P<0.05），亦為陰道分娩新生兒相對較高。肺部感染、發熱等合併症發病率並無差異。破膜方式在新生兒感染相關指標無明顯差異。結論：孕35～37週對孕婦常規進行直腸、陰道分泌物GBS培養篩查；對篩查結果陽性的孕婦產程中預防性使用抗生素，且在分娩前4h內用藥，如果剖宮產前胎膜未破則無需抗生素預防；在保證預防性使用抗生素的條件下，可根據產科指征實行人工破膜，並不會增加新生兒感染的幾率。
並列摘要
Objective: To explore the incidence of group B streptococcal infection of pregnant women, relationships between delivery mode and neonatal outcomes in Macau. Methods: 171 patients with GBS infection in late pregnancy were studied, genital tract bacterial culture were performed in third trimester; neonates ear, pharynx, nasal swab culture, body temperature, chest X-ray, CBC and CRP were set as neonatal infection observation indicators; clinical characteristics of pregnant women (including gestational age, parity, age, delivery mode, rupture of ways, nature of amniotic fluid etc.) were studied by using SPSS 13.0 chi-square analysis. Results: The positive rate difference of vaginal delivery and cesarean section delivery in neonatal group B streptococcal ear culture was (P <0.05), neonatal infection rate was higher in vaginal delivery, neonatal white blood cells total count difference were (P <0.05 ), showing relatively higher neonatal leukocytes in vaginal delivery. Due to group B streptococci causing neonatal lung infection, the incidence of fever and other complication had no difference. Artificial and natural rupture of membranes in the neonatal infections showed no significant difference. Conclusion: Rectal and vaginal secretions GBS screening culture were routinely performed in 35-37 weeks of gestation in pregnant women; prophylactic antibiotics were prescribed for positive screening pregnant women during delivery 4hours before labour, if fetal membranes were not ruptured before cesarean section no prophylactic antibiotics were required; artificial rupture of membranes according to obstetric indications implementation in prior prophylactic antibiotics does not increase the risk of neonatal infection.