Study On The Relationship Between Genital Tract Group B Streptococcus Infection And Adverse Pregnancy Outcomes Of Pregnant Women In Dali Area

Objective:To explore whether group B Streptococcus（GBS）infection in the genital tract of femininities in the third trimester of pregnancy in Dali area can lead to a variety of adverse maternal and infant pregnancy outcomes,analyze the related risk factors that may lead to GBS infection,study the drug susceptibility of GBS,strengthen the prevention and treatment of GBS infection,and reduce adverse pregnancy outcomes.Methods:In this study,the electronic medical record system of Dali Prefecture People’s Hospital was used to collect the data of pregnant women who gave birth in the obstetrics department of our hospital from January 2016 to December 2021.246 pregnant femininities with GBS positive were summarized in the GBS group.And 250 pregnant femininities with negative GBS screening during the same period were collected and summarized in the matched group.Statistical analysis of general data,clinical data,laboratory test data,pregnancy complications,pregnancy outcome and drug sensitivity were carried out for GBS group and control group.Results:1.Comparing the ordinary information of GBS group and matched group,the average age and average gestational age of GBS group were（29.73±4.31）years and（38.81±1.74）weeks,respectively,and the average age and average gestational age of matched group were（29.09±3.69）years and（38.56±1.62）weeks.There was no meaningful difference in age and gestational age between the two tranches（P>0.05）.There were no meaningful differences in BMI,pregnancy times,and delivery times between the two tranches（P>0.05）,suggesting that the two groups had relatively homogeneous baseline characteristics.2.There were meaningful differences between the GBS group and the matched group in gestational age,pregnancy complicated with vaginitis,and percentage of mononuclear cells（P<0.05）.In terms of whether the pregnant woman is primiparous,the number of abortions,blood type,ethnic category,the number of prenatal examinations,educational level,whether there was pregnancy-associated hypertension,whether there was pregnancy-associated diabetes mellitus,whether there was pregnancy-abnormal thyroid function,white blood cell number,the percentage of neutrophils,percentage of lymphocytes,CRP and PCT,there was no meaningful difference between the two tranches（P>0.05）.3.Univariate and multivariate Logistic regression analysis of all the above variables showed that relatively low percentage of monocytes,pregnancy complicated with vaginitis,and gestational age ≥35 years could significantly affect pregnant women with GBS infection（P<0.05）,and were risk factors for GBS infection in childing femininities.4.Compared with the bad pregnancy results of pregnant femininities in the GBS group and the matched group,the occurrence rates of intrauterine infection,postpartum hemorrhage,amniotic fluid fecal staining,intrauterine distress,cesarean section,and premature birth in the GBS group were 1.6%,9.8%,13.4%,4.1%,45.9%,and 8.1%,respectively;the control group were 2.8%,7.2%,6.8%,1.6%,36.4%,and 12.4%,respectively.Comparing the two tranches,there was a statistically meaningful difference in the occurrence rates of meconium-staining amniotic fluid and cesarean section（P<0.05）,but in terms of the incidence rates of intrauterine infection,postpartum hemorrhage,intrauterine distress and premature birth,the difference between the two tranches was not statistically meaningful.（P>0.05）.5.Adverse pregnancy results of newborns compared between GBS group and matched group,the occurrence rates of neonatal GBS infection,neonatal asphyxia,pneumonia,sepsis,death,hyperbilirubinemia,and transfer to pediatrics in the GBS group were9.8%,1.6%,2.0%,2.0%,0.4%,11.4%,and 35.0%,respectively.And the control group were 0,4.4%,0.4%,0.4%,0.4%,11.2%,and 23.6%,respectively.Comparing the two tranches,there were meaningful differences in the occurrence rates of neonatal GBS infection and transfer to pediatrics（P<0.01）,and in terms of the occurrence rates of neonatal asphyxia,death,hyperbilirubinemia pneumonia,and sepsis,the difference was not statistically meaningful（P>0.05）.6.The consequence of the drug susceptibility test of GBS group was that the resistance rates of clindamycin,levofloxacin,moxifloxacin and ampicillin were 80.6%,55.4%,54.7% and 0.4%,respectively.GBS was sensitive to penicillin G,linezolid,vancomycin,and tigecycline,the resistance rates were all 0.Conclusion:1.Pregnancy complicated with vaginitis,gestational age ≥35 years old,and relatively low percentage of mononuclear cells are risk factors for vaginal GBS infection in femininities in the third trimester.2.GBS infection in the reproductive tract of pregnant women can increase the incidence of amniotic fluid fecal infection and cesarean section,and has no meaningful relevancy with intrauterine infection,postpartum hemorrhage,intrauterine distress and premature birth.3.GBS infection in the reproductive tract of pregnant women can increase the incidence of neonatal GBS infection and transfer to pediatrics,and has no meaningful relevancy with neonatal asphyxia,pneumonia,sepsis,death,and hyperbilirubinemia.4.The resistance rates of ampicillin,penicillin G,vancomycin,tigecycline,and linezolid are low,and obstetricians can use them according to drug sensitivity;while the resistance rates of clindamycin,levofloxacin,and moxifloxacin are all more than50%,obstetricians should use it with caution or disable it.