The Clinical Study Of Group B Streptococcus In Pregnant Women And Its Preventive Antibiotic Treatment

Objective:Group B Streptococcus(GBS)is a gram positive B hemolytic streptococcus.It is an important pathogen of maternal reproductive tract in urinary system infection,maternal chorioamnionitis and puerperal infection.In addition,GBS infection can cause neonatal pneumonia,neonatal septicemia and even death.Therefore,how to screen and prevent pregnant women from infected GBS has become a focus of attention.However,only in recent years has it been recognized in mainland China that GBS infection is harmful to mother and child and there has been little relevant research.This study focused on the prevalence and affecting factors of GBS infection in pregnant women and the maternal and neonatal outcomes of prophylactic antibiotic therapy for GBS pregnant women with lobar or rupture of membranes.Methods:1027 cases of pregnant women were chosen in North China Pharmaceutical Workers Hospital from February 2015 to December 2017.GBS specimens from both outpatient pregnant women at 35-37 weeks gestation and pregnant women of premature labor or premature rupture of membranes after admission were collected from 1/3 of the lower vagina and 2-3 cm above the anal sphincter.All the specimens were preserved at 2-8℃and sent to the laboratory within 24 hours.GBS was detected by fluorescent labeling polymerase chain reaction(PCR).53 cases with positive GBS were the study group,to which penicillin or clindamycin was given in the beginning of labor or rupture of membranes.Another 974 cases of GBS negative were taken as the control group.In the study group,53 newborns were born and 974cases in the control group.Statistical data were analyzed by SPSS 22.0.Results:1.Comparison of general data in pregnant women between the study group and the control group.In the study group,the age of pregnant women was(27.15±4.11)years old.The BMI of pregnant women was(22.47±1.96)kg/m~2.The screening gestational age of pregnant women was(35.81±0.81)weeks.The number of years of education was(14.20±1.94)years.The number of production was(0.92±0.26)times.In the control group,the age of pregnant women was(26.45±5.39)years old.The BMI of pregnant women was(22.02±2.78)kg/m~2.The screening gestational age of pregnant women was(35.56±1.05)weeks.The number of years of education was(14.57±2.98)years.The number of production was(0.95±0.51)times.There was no significant difference in the general data between the two groups(P>0.05)(see Table1).2.Comparison of perinatal indexes in pregnant women between the study group and the control group.In the study group,the amount of postpartum hemorrhage was(371.24±80.06)ml.The neonatal birth weight was(3.52±0.31)g.The delivery time was(10.42±2.53)h.In the control group,the amount of postpartum hemorrhage was(360.15±105.27)ml.The neonatal birth weight was(3.35±0.67)g.The delivery time was(10.06±3.49)h.There was no significant difference in the perinatal indexes between the two groups(P>0.05)(see Table2).3.Analysis of influential factors of GBS in pregnant women.In this study,the GBS positive rate of urban residents was 6.93%while the GBS positive rate of non-urban residents was 3.72%.The GBS positive rate of pregnant women with a history of spontaneous abortion was 8.80%while the GBS positive rate of pregnant women without a history of spontaneous abortion was 4.19%.The GBS positive rate of pregnant women with gestational diabetes mellitus was 9.09%while the GBS positive rate of pregnant women without gestational diabetes mellitus was 4.47%.In this study,the GBS positive rate of the urban residents was significantly higher than that in non-urban residents.The GBS positive rate of pregnant women with spontaneous abortion history or gestational diabetes mellitus was significantly higher than that without spontaneous abortion history or gestational diabetes mellitus(P<0.05).The positive rate of GBS in pregnant women with hypertension was 4.83%while the positive rate of GBS in pregnant women without hypertension was 5.18%.The positive rate of GBS in pregnant women with hypertension was not significantly different from it in pregnant women without hypertension(P>0.05)(see Table3).4.Comparison of the incidence of maternal and neonatal adverse events in the study group and control group.In the study group,the incidence of premature rupture of membranes was11.32%.The incidence of premature delivery was 5.66%.The incidence of intrauterine infection was 0.00%.The incidence of puerperal infection was0.00%.In the control group,the incidence of premature rupture of membranes was 8.21%.The incidence of premature delivery was 4.93%.The incidence of intrauterine infection was 0.10%.The incidence of puerperal infection was1.23%.There was no significant difference in the incidence of maternal adverse events between the two groups(P>0.05)(see Table4).In the study group,the incidence of neonatal asphyxia was 5.66%.The incidence of neonatal septicemia was 0.00%.The incidence of neonatal pneumonia was 0.00%.The incidence of neonatal meningitis was 0.00%.In the control group,the incidence of neonatal asphyxia was 2.77%.The incidence of neonatal septicemia was 0.00%.The incidence of neonatal pneumonia was 1.64%.The incidence of neonatal meningitis was 0.00%.There was no significant difference in the incidence of neonatal adverse events between the two groups(P>0.05)(see Table5).Conclusions:1.In this study,the infection rate of GBS in pregnant women is 5.16%.The pregnant women living in urban areas or with spontaneous abortion history and diabetes mellitus are more likely to suffer from GBS infection.2.There were no adverse events between maternal and infant when GBS pregnant women were given prophylactic antibiotics treatment at the beginning of labor or rupture of membranes.Then it improve the maternal and infant outcomes.