Maternal Obesity and Rectovaginal Group B Streptococcus Colonization at Term.
Maternal Obesity and Rectovaginal Group B Streptococcus Colonization at Term.
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DOI：
10.1155/2015/586767
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发表时间：
2015
影响因子：
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通讯作者：
Tuuli MG
中科院分区：
文献类型：
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作者：
Kleweis SM;Cahill AG;Odibo AO;Tuuli MG
Objective.验证母体肥胖是足月时直肠阴道B族链球菌（GBS）定植的独立危险因素这一假设。研究设计.在Barnes-Jewish医院（2004-2008年）接受分娩的单胎足月妊娠连续女性的回顾性队列研究。母亲BMI ≥ 30 Kg/m2（肥胖）或<30 Kg/m2（非肥胖）定义为两个对照组。感兴趣的结果是来自阳性培养物的GBS定殖。使用Student t检验和卡方或Fisher精确检验比较基线特征。采用单变量和多变量分析评估肥胖和GBS定植之间的关联。结果在10，564名符合条件的女性中，有7，711名符合入选标准。整个队列中GBS定植的患病率相对较高（25.8%）。肥胖孕妇GBS定植率明显高于非肥胖孕妇（28.4%比22.2%，P < 0.001）。在调整种族、产次、吸烟和糖尿病后，肥胖孕妇GBS检测阳性的可能性仍比非肥胖妇女高35%（调整OR 1.35 [95%CI 1.21-1.50]）。结论母亲肥胖是足月时GBS定植的重要危险因素。需要进一步的研究来评估这一发现对基于风险的管理策略的影响。
Objective. To test the hypothesis that maternal obesity is an independent risk factor for rectovaginal group B streptococcus (GBS) colonization at term. Study Design. Retrospective cohort study of consecutive women with singleton term pregnancies admitted in labor at Barnes-Jewish Hospital (2004–2008). Maternal BMI ≥ 30 Kg/m2 (obese) or <30 Kg/m2 (nonobese) defined the two comparison groups. The outcome of interest was GBS colonization from a positive culture. Baseline characteristics were compared using Student's t-test and Chi-squared or Fisher's exact test. The association between obesity and GBS colonization was assessed using univariable and multivariable analyses. Results. Of the 10,564 women eligible, 7,711 met inclusion criteria. The prevalence of GBS colonization in the entire cohort was relatively high (25.8%). Obese gravidas were significantly more likely to be colonized by GBS when compared with nonobese gravidas (28.4% versus 22.2%, P < 0.001). Obese gravidas were still 35% more likely than nonobese women to test positive for GBS after adjusting for race, parity, smoking, and diabetes (adjusted OR 1.35 [95% CI 1.21–1.50]). Conclusion. Maternal obesity is a significant risk factor for GBS colonization at term. Further research is needed to evaluate the impact of this finding on risk-based management strategies.