| Objective : Through the detection of group B streptococcus(GBS)in the genital tract of pregnant women in western Yunnan,to understand its colonization status and related influencing factors,and to provide a basis for formulating prevention and intervention measures.Methods : The subjects of this study were pregnant women who visited and delivered in the obstetrics department of the First Affiliated Hospital of Dali University and Dali Maternal and Child Health Hospital from October 2020 to October 2022,including 4,975 pregnant women of Han and ethnic minorities from 8 states and cities in western Yunnan.The bacterial culture of vaginal and rectal secretions was performed simultaneously in a sterile tube,and the GBS colonization was grouped according to age,nationality and residence.Then 294 cases of GBS positive in secretion bacterial culture were included in GBS positive group,and 295 cases of pregnant women with negative secretion bacterial culture were randomly selected in GBS negative group.The clinical data of pregnant women were collected and statistically analyzed.SPSS26.0 software was used for statistical analysis.The count data were expressed as a percentage.The chi-square test was used for comparison between groups.Multivariate analysis was performed using logistic regression analysis.P<0.05 indicated that the difference was statistically significant.Results:1.The survey of 4975 pregnant womenThe colonization of GBS in the genital tract of 4975 pregnant women in western Yunnan : The colonization rate of GBS was 5.90%(294/4975).Comparison of age groups :the colonization rate of ≥ 35 years old group was the highest 8.30%(72/867),and the colonization rate of 26-34 years old group was the lowest 5.10%(159/3112).The difference of colonization rate among different age groups was statistically significant(P<0.05).Comparison between ethnic groups : the colonization rate of the Bai group was the highest 7.32%(159/2172),and the colonization rate of the Tibetan group was the lowest 3.75%(8/213).There was a statistically significant difference in GBS colonization rate between ethnic groups(P<0.05).Comparison of residence : the highest colonization rate was 6.75%(193/2857)in Dali group,and the lowest colonization rate was 3.84%(2/52)in Lincang group.There was no significant difference in GBS colonization rate among different residences(P>0.05).2.The survey of 589 pregnant women.1.There was no significant difference in age and gestational age between 294 GBS positive pregnant women and 295 GBS negative pregnant women(P<0.05).2.Analysis of influencing factors of reproductive tract GBS colonization in 589 pregnant women in western Yunnan: In univariate analysis,294 pregnant women in the GBS positive group and 295 pregnant women in the GBS negative group were compared in terms of previous abortion history,gestational obesity,gestational diabetes history,gestational vaginitis history,gestational anemia,asymptomatic bacteriuria and other data,and the differences were statistically significant(P < 0.05).There was no significant difference in the history of vaginal delivery,preterm delivery,hypertensive disease during pregnancy,thyroid dysfunction during pregnancy,fetal protection during pregnancy and other related factors(P > 0.05).In multivariate analysis,previous abortion history,gestational obesity,gestational diabetes history,gestational vaginitis history,gestational anemia and asymptomatic bacteriuria were risk factors for genital GBS colonization.3.Analysis of pregnancy outcomes of 589 pregnant women with genital tract GBS colonization in western Yunnan : GBS positive group premature rupture of membranes19.72%(58/294),premature 9.86%(29/294),histopathological chorioamnionitis 20.40%(60/294),puerperal infection 2.04%(6/294),postpartum hemorrhage 11.22%(33/294).In GBS negative group,premature rupture of membranes was 11.52%(34/295),premature delivery was 4.40%(13/295),histopathological chorioamnionitis was 13.89%(41/295),puerperal infection was 1.01%(3/295),and postpartum hemorrhage was 6.06%(12/295).The adverse pregnancy outcomes of pregnant women in the GBS positive group were higher than those in the GBS negative group.The adverse pregnancy outcomes of premature rupture of membranes,premature delivery,histopathological chorioamnionitis and postpartum hemorrhage were compared between the two groups.The difference was statistically significant(P<0.05).There was no significant difference in puerperal infection(P>0.05).4.Neonatal outcome analysis of 589 pregnant women with GBS colonization in the reproductive tract in western Yunnan : GBS positive group neonatal pathological jaundice12.24%(36/294),low birth weight 9.52%(28/294),neonatal pneumonia 10.54%(31/294),neonatal asphyxia 4.08%(12/294),neonatal sepsis 2.38%(7/294).In GBS negative group,neonatal pathological jaundice was 6.78%(20/295),low birth weight was 3.73%(11/295),neonatal pneumonia was 4.41%(13/295),neonatal asphyxia was 2.71%(8/295),neonatal sepsis was 1.02%(3/295).The incidence of neonatal adverse outcomes in the GBS positive group was higher than that in the GBS negative group.The adverse outcomes of neonatal pathological jaundice,low birth weight infants and neonatal pneumonia were compared between the two groups,and the difference was statistically significant(P<0.05).There was no significant difference in neonatal asphyxia and neonatal sepsis(P>0.05).Conclusion :1.The colonization rate of GBS in the reproductive tract of pregnant women in western Yunnan was 5.90%,which was lower than the national average colonization rate of 8.1%.2.The colonization of GBS in the reproductive tract of pregnant women in western Yunnan was related to residence,age and nationality.The highest colonization rate was6.75% in Dali Prefecture,8.30% in age ≥ 35 years old,and 7.32% in Bai nationality.3.GBS colonization in the reproductive tract of pregnant women in western Yunnan is related to many factors.Previous abortion history,pregnancy with obesity,gestational diabetes history,gestational vaginitis history,pregnancy with anemia and asymptomatic bacteriuria during pregnancy are risk factors for GBS colonization.4.The incidence of adverse pregnancy outcomes and adverse neonatal outcomes in pregnant women with genital tract GBS colonization in western Yunnan was higher than that in pregnant women without colonization. |
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