孕晚期B族链球菌定植对孕妇阴道微生态及新生儿结局的影响
The effects of group B streptococcus colonization during late pregnancy on vaginal microbiota and neonatal outcomes
韩玥 1尉进茜 1王亚娟 2廖琪3
作者信息
- 1. 北京市顺义区妇幼保健院新生儿科,北京 101300
- 2. 首都儿科研究所附属儿童医院新生儿内科,北京 100020
- 3. 北京市顺义区妇幼保健院产科,北京 101300
- 折叠
摘要
目的 探讨孕晚期B族链球菌(group B streptococcus,GBS)定植对孕妇阴道微生态及新生儿结局的影响.方法 选择2020年9月至2021年9月于北京市顺义区妇幼保健院接受产前检查并分娩的孕妇进行前瞻性研究,根据孕妇阴道分泌物GBS培养和(或)聚合酶链式反应检测结果将孕妇分为GBS阳性组和GBS阴性组,根据新生儿是否存在早发感染将孕妇分为早发感染组和非早发感染组,比较不同组间孕妇阴道微生态情况及新生儿结局.结果 共纳入125例孕妇,其中GBS阳性组65例(52.0％)、GBS阴性组60例(48.0％);早发感染组24例(19.2％)、非早发感染组101例(80.8％).GBS阳性组孕妇胎膜早破、羊水污染、绒毛膜羊膜炎、新生儿早发感染比例明显高于阴性组,差异有统计学意义(P＜0.05).孕妇GBS阳性组阴道菌群中链球菌属和脲原体属丰度高于GBS阴性组(P＜0.01),而红球菌属、叶杆菌属、双歧杆菌属丰度低于GBS阴性组(P＜0.05).早发感染组孕妇肠球菌属丰度高于非早发感染组,差异有统计学意义(P＜0.05).GBS阳性且存在新生儿早发感染组的孕妇阴道菌群中大肠埃希-志贺菌属丰度较其余3组高,GBS阳性但未发生新生儿早发感染组的孕妇阴道菌群中加德纳氏菌属丰度较其余3组高,差异均有统计学意义(P＜0.05).结论 孕妇GBS定植增加胎膜早破、羊水污染、绒毛膜羊膜炎、新生儿早发感染的发生风险.GBS定植导致孕妇阴道菌群结构紊乱,阴道菌群中脲原体属、链球菌属、大肠埃希-志贺菌属、肠球菌属的增加可能与新生儿早发感染的发生相关.
Abstract
Objective To study the effects of group B streptococcus(GBS)colonization during late pregnancy on vaginal microbiota and neonatal outcomes.Methods From September 2020 to September 2021,pregnant women receiving prenatal care and delivered in our hospital were prospectively enrolled.They were assigned into GBS(+)group and GBS(-)group based on the results of GBS culture and/or PCR tests of vaginal secretions.The mothers were also assigned into early-onset infection(EO)group and non-early-onset infection(non-EO)group based on the presence or absence of early-onset infection of their neonates.The vaginal microbiota and neonatal outcomes were compared between these groups.Results A total of 125 cases were enrolled,including 65(52.0％)in GBS(+)group and 60(48.0％)in GBS(-)group.24 cases(19.2％)were in EO group and 101 cases(80.8％)in non-EO group.The incidences of premature rupture of membranes(PROM),amniotic fluid contamination,chorioamnionitis and early-onset neonatal infection in GBS(+)group were significantly higher than GBS(-)group(allP＜0.05).The abundances of Streptococcus and Ureaplasma in vaginal flora of GBS(+)group were higher than GBS(-)group(P＜0.01),whereas Rhodococcus,Phyllobacterium and Bifidobacterium were lower than GBS(-)group(P＜0.05).The EO group had significantly higher abundance of enterococcus than the non-EO group(P＜0.05).Mothers with GBS colonization and neonates with early-onset infection had the highest abundance of Escherichia/Shigella(P=0.04).Mothers with GBS colonization and neonates without early-onset infection showed the highest abundance of Gardnerella(P=0.04).Conclusions GBS colonization during late pregnancy increases the incidences of PROM,amniotic fluid contamination,chorioamnionitis and early-onset neonatal infection.GBS colonization causes abnormal vaginal flora in pregnant women.The increases of Ureaplasma,Streptococcus,Escherichia/Shigella and Enterococcus in vaginal microbiota maybe associated with early-onset neonatal infection.
关键词
B族链球菌/孕妇/阴道微生态/16SrDNA/新生儿结局Key words
Group B streptococcus/Pregnant woman/Vaginal microbiota/16S rDNA/Neonatal outcome引用本文复制引用
出版年
2024
NETL
NSTL
万方数据