胎膜早破孕妇GBS带菌现状及阴道微生物群失调对母婴结局的影响

Objective To analyze the colonization status of Group B Streptococcus(GBS) in pregnant women with premature rupture of membranes(PROM) and the impact of vaginal microbiota imbalance on maternal and neonatal outcomes. Methods A total of 240 full-term pregnant women admitted to our hospital from January 2021 to June 2023 were enrolled as research subjects, including 120 cases with premature rupture of membranes(observation group) and 120 cases without premature rupture of membranes(control group), with equal sample size in both groups. The colonization rate of GBS, incidence of vaginal microbiota imbalance, and their impacts on maternal and neonatal outcomes were compared between the two groups. Results There was no significant difference in vaginal cleanliness between the two groups(P>0.05). Compared with the control group, the observation group had a higher proportion of cases with vaginal pH>4.5(62.50%), a higher GBS colonization rate(20.83%), and a higher incidence of vaginal microbiota imbalance(47.50%), with statistically significant differences(P<0.05). In the observation group, there were no significant differences in the incidence rates of neonatal pneumonia, chorioamnionitis and fetal distress between pregnant women with vaginal microbiota imbalance and those with normal vaginal microbiota(P>0.05). The total incidence of adverse outcomes including neonatal pneumonia(16.00%), chorioamnionitis(16.00%) and fetal distress(8.00%) in GBS-positive pregnant women was 40.00%, which was significantly higher than that in GBS-negative pregnant women(9.47%), with a statistically significant difference(P<0.05).Conclusion For maternal and neonatal outcomes, the vaginal microbiota imbalance of pregnant women with premature rupture of membranes has no effect on it, but GBS carrier has a great impact on it. GBS carrier status of pregnant women should be paid great attention in clinical practice.