Analysis Of Positive Factors And Local Treatment Of Group B Streptococcus Screening In Third Trimester Of Pregnancy

Objective:To statistically analyze the positive status of Group B Streptococcus（GBS）screening in pregnant women in the third trimester of pregnancy,the influencing factors and the application effect of local intervention treatment.To explore the clinical significance of screening and treatment of GBS during pregnancy in this area.Methods:The clinical data of 600 pregnant women who were screened for GBS in 32-40 weeks of pregnancy and delivered in hospital from May2020 to August 2021 were retrospectively investigated,as well as the positive status of GBS screening in the third trimester of pregnancy in minority areas of Xiangxi.The positive status of GBS in different screening weeks were compared,as well as the clinical data of pregnant women with positive and negative GBS screening.The high risk factors affecting the colonization of GBS in the third trimester of pregnancy by multivariate Logistic regression analysis were found out.GBS positive pregnant women were divided into intervention group and non-intervention group according to the wishes of pregnant women and whether they were treated with nifurfuryl nystatin vaginal ointment combined with Honghe Fujie lotion for one week.The GBS negative status of pregnant women in the two groups was randomly matched and compared,and the local drug treatment effect was evaluated.Results:The results obtained by the above methods are as follows:（1）Among 600 pregnant women in the third trimester of pregnancy,80 cases were positive for GBS screening,and the overall positive rate was 13.33%.Among 80 pregnant women who were positive for GBS screening,49 cases were complicated with vaginal inflammation,accounting for 61.25%of the total.（2）The positive rates of GBS screening were 12.07%,17.42%and 9.09%at 32-34⁺⁶weeks,35-37⁺⁶weeks and 38-40 weeks,respectively.The positive rate of GBS screening was the highest at 35-37⁺⁶weeks,and the difference was statistically significant（P<0.05）.（3）Compared with GBS negative pregnant women,GBS positive women were correlated with age,Body Mass Index（BMI）,abortion history,gestational age,gestational diabetes mellitus（GDM）,hypertensive disorder complicating pregnancy（PHD）and vaginal infection（χ2 19.621,33.319,4.335,5.410,8.553,7.218,70.221,P<0.05）.Age≥35 years old,BMI≥28kg/m2and vaginal inflammation are the high risk factors affecting the positive colonization of GBS in pregnant women in Xiangxi minority areas（OR=2.308,3.645,6.204,P<0.05）.（4）Among 30pregnant women in intervention group,14 were negative for GBS,and the negative rate of GBS was 46.66%;Among the 30 pregnant women in the non-intervention group,6 were negative for GBS,and the negative rate of GBS was 20%.The difference between the two groups was statistically significant（χ²=4.8,P<0.05）,and no adverse events occurred.Conclusion:The positive rate of GBS screening in minority areas is 13.33%,which is higher than the 8-11.8%reported in China,and the risk of colonization infection of GBS during pregnancy in this area is higher.The positive rate of GBS screening is related to the gestational age of screening,and the detection rate of screening in 35-37⁺⁶weeks of pregnancy is the highest.Age≥35 years old,BMI≥28kg/m2and vaginal inflammatory infection are the high risk factors affecting GBS colonization during pregnancy in this area.Local drug therapy is safe and effective in GBS positive pregnant women during pregnancy.The positive rate and colonization rate of GBS screening during pregnancy in this area are high,so GBS screening of pregnant women in this area should be strengthened.Based on high-risk factors such as obesity and vaginal inflammation,we should strengthen health education for women of childbearing age,and strengthen weight control and individualized nutrition management for pregnant women before and during pregnancy.GBS colonization is different in different gestational weeks.Increasing screening times to know the positive situation of GBS in pregnant women and timely carrying out vaginal local drug intervention can reduce the colonization infection of GBS in pregnant women,reduce the use of antibiotics and reduce the occurrence of diseases related to GBS infection in mothers and children.It is of great clinical significance to carry out and popularize screening and intervention treatment of GBS during pregnancy in this area.