| ObjectiveTo study the rate of maternal colonation of group B streptococcus (GBS) by detected with the polymerase chain reaction (PCR) in late pregnant women and its perinatal outcome.MethodsA study was carried out in our hospital in china between April 2013 and November 2013. Select prenatal pregnancy women 898 cases in the 35-37 weeks of gestation, collect secretion from a third under the vagina and around the anus, using fluorescent polymerase chain reaction (PCR) method to detect GBS carrier, according to the test results, pregnancy women are divided into two groups:GBS positive group and GBS negative group, and to observe and compare maternal pregnancy outcome and neonatal outcome of two groups.Results1. Detection rate of Group B streptococcus:898 cases of pregnant women,68 cases of GBS positive group, accounting for the 7.60%; 830 cases negative groups, accounting for 92.40%.2. The relevant influencing factors:the average age in pregnant women with GBS positive was (30.06±3.33), the average age in pregnant women of control group (GBS negative)was (29.97±3.78); the average gestional weeks of observation group where GBS tested positive was (37.20±1.26), the average gestional age in control group (GBS negative)was (37.04±1.01); the average number of pregnancy in pregnant women with GBS positive was (1.79±0.84), when the average times of pregnancy in pregnant women with GBS negative was (1.69±0.96); contrast with the average delivery times of pregnant women with GBS positive (1.79±0.84), the average delivery times of pregnant women with GBS negative was (1.69±0.96); GBS positive rate of multipara was 10.10%(10/99), GBS positive rate of women in primiparity was 7.30% (58/799); GBS positive rate of Older pregnant women (more than 35 years old) was 8.40% (7/83), GBS positive rate of aged less than 35 years old was 7.50%(61/815), the positive rate is slightly higher than the latter. GBS positive rate with Number of abortions (greater than or equal to 3 times) was 11.10%(4/36), GBS positive rate with with abortion times less than 3 times were 7.40%(64/862), the former GBS positive rate is also higher than the latter. The women’s age, gestational age, times of pregnancy, whether or not for the first-timer, old age and times of abortions, between two groups are all without significant difference (P> 0.05). The positive rate of GBS during hypothyroidism in pregnant women was 4.80%, the positive rate of GBS during non hypothyroidism in pregnant women was 7.70%, the difference was not significant (P> 0.05); the positive rate of GBS in the field of the floating population was 11.10%, the positive rate of GBS of the local resident population was 6.00%, the difference was significant (P< 0.05); the positive rate of GBS in diabetic pregnant women during pregnancy was 20%, the positive rate of GBS in non diabetic pregnant women during pregnancy was 7.20%, the difference was significant (P< 0.05); the positive rate of GBS in obese patients was 7.5%, the positive rate of GBS in non obese patients was 7.5%, the difference was significant(P< 0.05).3. The pregnancy outcome of mother and baby:(1). GBS positive group intrauterine infection rate was 14.70%, GBS negative group intrauterine infection rate was 4.60%; Eliminate cases undergoing elective cesarean delivery, GBS positive group intrauterine infection rate was 10.42%, GBS negative group intrauterine infection rate was 3.77%; the GBS positive group of premature rupture of membranes rate was 30.90%, the GBS negative group of premature rupture of membranes rate was 19.60%; the GBS positive group of fetal distress rate was 39.70%; the GBS negative group of fetal distress rate was 20.20%; the GBS positive group postpartum hemorrhage rate was 13.20%, the GBS negative group postpartum hemorrhage rate was 5.70%; The GBS positive group in intrauterine infection, intrauterine infection with eliminating cases undergoing elective cesarean deliverypremature rupture of membranes, fetal distress and postpartum hemorrhage rates were significantly higher than in GBS negative group (P< 0.01). incidence of cesarean section in GBS positive was 44.10%(30/68), incidence of cesarean section in GBS negative was 43.10%(358/830), GBS positive incidence of neonatal asphyxia was 1.6%(1/62), negative group the incidence of neonatal asphyxia was 0.1%(1/774); GBS positive incidence of amniotic fluid contamination was 17.60%(12/68), GBS negative incidence of amniotic fluid contamination was 16.00%(133/830);the GBS positive group Puerperal infection rate was 2.90%, the GBS negative group Puerperal infection rate was 5.20%; GBS positive incidence of premature birth was 7.40%(51/682), GBS negative incidence of premature birth was 5.70%(47/830). Comparison of the two groups in the mode of delivery, amniotic fluid contamination, Puerperal infection and premature delivery, there were no significant difference (P> 0.05).(2). Casess in group of GBS positive were 68, of which neonatal infectious diseases was 22 cases (32.40%,22/68), GBS negative of pregnant women in neonatal infectious diseases was 93 cases (11.20%,93/830). The neonatal infection rate in GBS positive group was no difference with group of GBS negative (P> 0.05). The negative group have 3 cases of pneumonia, including 2 cases for GBS culture positive; The infection rate of newborn in GBS observation group (GBS positive) was (1.5%) and compared with the control group (0.2%), there was no significant difference (P> 0.05), and the GBS was not seen in other infectious diseases (except pneumonia).Conclusion1. Chronic disease of pregnancy (gestational diabetes mellitus, gestational hypertension, gestional fat) were risk factors for GBS carriers.2. Colonization of group B streptococcus in Pregnant women of late pregnancy, significantly increased the incidence rate of intrauterine infection, premature rupture of membranes, postpartum hemorrhage, fetal distress and neonatal infection disease, and have adverse effects on pregnancy outcome, we should actively carry out GBS prenatal screening and prevention of GBS infection.3. The floating population can increase the risk of GBS infection, and is a risk factor for GBS carrier. |
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