妊娠晚期阴道B族链球菌的感染对肠道菌群和妊娠结局的影响

目的探究妊娠晚期阴道B族链球菌(group B Streptococcus,GBS)的感染对肠道菌群和妊娠结局的影响。方法选取2018年3月至2019年11月大连市中心医院孕检并分娩的妊娠妇女744人为对象,调查并统计B族链球菌的感染率;筛选有和没有B族链球菌感染妊娠妇女各47人,调查不良妊娠结局的发生率;选取信息匹配的妊娠晚期阴道B族链球菌感染和未感染的妊娠妇女,采集粪便样本,提取菌群DNA,用16S rDNA方法分析菌群变化。结果744名妊娠妇女中B族链球菌检出49例,感染率为6.59%;B族链球菌感染组总的不良妊娠发生比例为76.6%,正常组发生比例为27.7%(χ^2=5.491,P<0.05)。B族链球菌感染组妊娠妇女胎膜早破(χ^2=16.177,P<0.01)、难产(χ^2=21.134,P<0.01)和羊水异常(χ^2=22.989,P<0.05)的发生率与未感染组比较显著增高。B族链球菌感染组妊娠妇女肠道菌群发生显著变化。结论妊娠晚期阴道B族链球菌的感染可能引起肠道菌群紊乱,增加不良妊娠结局。

Effect of group B Streptococcus infection in late pregnancy on intestinal microbiota and pregnancy outcomes

Objective To investigate the effect of group B Streptococcus(GBS) infection in late pregnancy on intestinal microbiota and pregnancy outcomes. Methods A total of 744 pregnant women were selected as the objects in Dalian Municipal Central Hospital from Mar 2018 to Nov 2019, and the infection rate of GBS was investigated and counted. The incidence of adverse pregnancy outcomes was in investigated by screening 47 pregnant women with and without GBS infection. Fecal samples of matched pregnant women with and without GBS infection in late pregnancy were collected, the bacterial community DNA was extracted and the bacterial community changes were analyzed with the 16 S rDNA method. Results Among the744 pregnant women, 49 cases of GBS infection were detected, and the carrier rate was 6.59%. The proportion of adverse pregnancy outcomes was 76.6% in pregnant women with GBS infection while 27.7% in that without GBS(χ^2=5.491,P<0.05). The incidence of premature rupture of membranes(χ^2=16.177,P<0.01), dystocia(χ^2=21.134,P<0.01)and abnormal amniotic fluid(χ^2=22.989,P<0.05)in the pregnant women with GBS infection were significant increased compared with that in the pregnant women without infection. The intestinal microbiota of pregnant women with GBS infection changed significantly. Conclusion The GBS infection may cause intestinal microbiota disorder and increase the adverse pregnancy outcome in late pregnancy.