B族溶血性链球菌带菌孕妇发生急性绒毛膜羊膜炎和脐带炎危险因素的病例对照研究

摘要

Objective To investigate the risk factors of acute chorioamnionitis and funisitis in pregnant women carrying group B streptococcus (GBS) and undergoing vaginal delivery.Methods 129 full-term pregnant women who carried GBS and underwent vaginal delivery were enrolled from Bejing Obstetrics and Gynecology Hospital,Capital Medical University from June 2014 to January 2015.By reviewing the medical records,we collected their baseline characteristics and data concerning delivery.Furthermore,based on the pathological examination results,we assigned 27 with acute chorioamnionitis or funisitis and 102 without to the case group and control group,respectively.Results Multivariate Logistic regression analysis showed that amniotomy 〔OR=5.106,95%CI(1.535,16.987)〕,total duration of labor 〔OR=1.098,95%CI(1.013,1.191)〕, and neonatal birth weight 〔OR=1.002,95%CI(1.000,1.003)〕were risk factors for having acute chorioamnionitis and funisitis(P<0.05).Conclusion For full-term pregnant women with GBS and vaginal delivery,appropriately shortening the total duration of labor and reducing the possibilities of amniotomy could decrease the risk of acute chorioamnionitis and funisitis.%目的 探讨妊娠晚期B族溶血性链球菌(GBS)带菌孕妇经阴道分娩发生急性绒毛膜羊膜炎或脐带炎的高危因素.方法 回顾性分析2014年6月—2015年1月于首都医科大学附属北京妇产医院妊娠足月经阴道分娩的GBS带菌孕妇129例临床资料.根据病理检查有无急性绒毛膜羊膜炎或脐带炎,分为病例组(27例)和对照组(102例).查阅相关病历,记录GBS带菌孕妇一般资料及分娩信息.结果 多因素Logistic回归分析显示,人工破膜〔OR=5.106, 95%CI(1.535,16.987)〕、总产程时间延长〔OR=1.098,95%CI(1.013,1.191)〕、新生儿出生体质量〔OR=1.002, 95%CI(1.000,1.003)〕是GBS带菌孕妇发生急性绒毛膜羊膜炎或脐带炎的危险因素(P<0.05).结论 适当缩短总产程时间、减少人工破膜可能减低妊娠晚期GBS带菌孕妇阴道分娩时急性绒毛膜羊膜炎或脐带炎的发生风险.