Is antenatal group B streptococcal carriage a predictor of adverse obstetric outcome?
Is antenatal group B streptococcal carriage a predictor of adverse obstetric outcome?
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DOI：
10.1155/s106474490000017x
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发表时间：
2000-01-01
影响因子：
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通讯作者：
Ugoni, A M
中科院分区：
文献类型：
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作者：
Garland, S M;Kelly, N;Ugoni, A M
目的：虽然早发新生儿GBS败血症与早产和胎膜破裂时间延长呈正相关，但文献中关于母体GBS定植是否是不良产科结局的预测因素存在争议。这是一个关键的问题，以解决适当的管理（期待与介入管理）的患者出现早破膜，谁没有明显的败血症迹象，但谁是GBS定植。方法：自1981年以来，医院的政策是在28-32周时通过收集阴道低拭子对所有公立医院患者进行产前筛查，以检查生殖器携带的GBS。所有在产前有GBS定植的患者都给予青霉素作为产时化学预防。对所有gbs定植的产前患者（4495例患者中的580例）进行了为期12个月的回顾，并随机（每4例连续产前患者）对未定植的患者（958例）进行了回顾。使用单变量和多变量广义线性模型评估阴道下部GBS定植和其他早产危险因素。结果：研究组中母体GBS定植率为12.9%。当在多变量分析中控制共同变量时，产前GBS定植与早产和胎膜早破之间的关联不显著。结论：母体产前GBS不能预测早产。因此，对于胎膜破裂、未分娩且无脓毒症迹象的gbs患者，采用预期治疗是合适的。
OBJECTIVES: While early-onset neonatal GBS sepsis is positively associated with premature birth and prolonged rupture of membranes, there is debate in the literature as to whether maternal GBS colonization is a predictor of adverse obstetric outcome. This is a critical issue to resolve for appropriate management (expectant vs. interventional management) of the patient presenting with premature rupture of membranes, who has no overt signs of sepsis, but who is colonized with GBS.METHODS: Since 1981 it has been hospital policy to screen all public patients antenatally for genital carriage of GBS by collection of a low vaginal swab at 28-32 weeks. All patients colonized with GBS antenatally are given penicillin as intrapartum chemoprophylaxis. Review of all GBS-colonized antenatal patients for a 12-month period (580 of 4,495 patients) and a randomized (every fourth consecutive antenatal patient) number of noncolonized patients (958) was made. Lower vaginal GBS colonization and other risk factors for preterm delivery were assessed using univariate and multivariate generalized linear modeling.RESULTS: In the study group, the maternal GBS colonization rate was 12.9%. When cofounding variables were controlled in a multivariate analysis, the association between antepartum GBS colonization and preterm labor and preterm rupture of membranes was not significant.CONCLUSION: Maternal antenatal carriage of GBS does not predict preterm labor. Therefore it is appropriate that expectant management occur for a GBS-colonized woman who ruptures her membranes, is not in labor, and has no evidence of sepsis.