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Associated Risk Factors in Group B Streptococcus Infection During Pregnancy HUANG Yan ，WANG Mingying ，FENG
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Junyan ，ZHANG Jie 1*
1.Department of Clinical Laboratory，Peking University International Hospital，Beijing 102206，China
2.Department of Obstetrics and Gynecology，Peking University International Hospital，Beijing 102206，China
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Corresponding author：ZHANG Jie，Chief physician；E-mail：zhangj@pkuih.edu.cn
【Abstract】 Background Group B streptococcus（GBS） infection can give rise to intrauterine infection during
pregnancy and postpartum endometritis，and increase the risk of premature birth or stillbirth. So it is essential to improve the
detection rate of GBS and to identify risk factors of GBS infection. Objective To explore the risk factors of GBS infection during
pregnancy. Methods Participants were pregnant women in late pregnancy（n=11 248） who were selected from Department of
Obstetrics and Gynecology，Peking University International Hospital from January 2017 to August 2021. All of them underwent
screening for GBS infection，4 479 of them used vaginal swab test（single-swab culture group），1 239 used vaginal and
rectal swabs tests（double-swab culture group），and other 5 530 used PCR test of vaginal and rectal swabs（double-swab &
PCR group），and GBS detection rates in the groups were compared. Then，from the double-swab & PCR group，305 cases
who were detected with GBS infection and 2 650 without were selected and compared in terms of information possibly related to
GBS infection collected from the medical records，by which potential intrapartum risk factors for GBS infection were identified
exploratively. Furthermore，294 of the above-mentioned 305 cases who also underwent vaginal microbiome test were selected，
and compared with a random sample of 367 of the above-mentioned 2 650 cases who also underwent vaginal microbiome test，to
analyze the association of vaginal microbiota status with GBS infection. Results The GBS detection rates in single-swab culture
group，double-swab culture group，and double-swab & PCR group were 5.94%（266/4 479），8.07（100/1 239），and
10.31%（570/5 530），respectively. The GBS detection rate was lower in single-swab culture group than that of other two groups
（P<0.017）. And double-swab & PCR group had a higher GBS detection rate than did double-swab culture group（P<0.017）.
Multiple Logistic regression analysis showed that grade Ⅲ or Ⅳ vaginal cleanliness was closely associated with the prevalence
of GBS infection in pregnancy〔OR=3.005，95%CI（1.220，7.403），P=0.017〕. Conclusion PCR test of both vaginal
and rectal swabs could increase the GBS detection rate. Vaginitis is a major high-risk factor associated with GBS infection during
pregnancy，which needs to be addressed in the process of diagnosis and treatment.
【Key words】 Pregnancy；Group B hemolytic streptococcus；Infections；Vaginitis；Root cause analysis

B 族溶血性链球菌（group B streptococcus，GBS） 组（n=1 239）和双拭子 -PCR 法组（n=5 530），进行
为 β 溶血性革兰阳性球菌，常定植于女性肠道和生殖 GBS 检测阳性率的组间差异分析。
道。由于妊娠期免疫力和雌激素水平的变化，GBS 可 选取 2019 年 2 月至 2021 年 8 月于北京大学国际医
引起孕妇尿路感染、宫内感染及产后子宫内膜炎，并增 院进行双拭子 -PCR 法筛查 GBS 阳性的孕妇 305 例，选
加早产或死胎风险 ［1］ 。另外，母体泌尿生殖道和胃肠 取同期、同方法检测 GBS 阴性的孕妇 2 650 例，查询病
道的定植菌是造成新生儿 GBS 早发性疾病（early-onset 历并记录相关资料进行产时高危因素对 GBS 感染的影
disease，EOD）的主要危险因素，感染 GBS 的孕妇中约 响分析。
50% 会在分娩期间或胎膜破裂后将细菌传播给新生儿， 选取双拭子 -PCR 法筛查 GBS 阳性同时在妊娠期进
如果未进行产时抗生素的预防，1%~2% 的新生儿会发 行了阴道微生态状态检测的孕妇 294 例，采用随机数字
生 GBS EOD ［2-3］ 。因此在提高 GBS 检出率的同时识别 表法从双拭子 -PCR 法筛查 GBS 阴性同时在妊娠期进
其高危因素十分重要，本研究拟从采样和检测方法上探 行了阴道微生态状态检测的孕妇中抽取孕妇 367 例，记
讨提高 GBS 检出率的途径并对孕妇自身可能存在的危 录相关资料进行阴道微生态与 GBS 关系的分析。
险因素进行分析，以期更好地进行围生期孕妇及新生儿 纳入标准：（1）妊娠 36 周或 40 周者，如果妊娠
的保健工作。 36 周检测后至 40 周未分娩，则纳入 40 周第 2 次检测
1 对象与方法 的结果；（2）顺利分娩者。排除标准：（1）采样 3 d
1.1 研 究 对 象 选 取 2017 年 1 月 至 2021 年 8 月 于 内有局部用药史；（2）存在心功能、肝功能或肾功能
北京大学国际医院妇产科进行 GBS 筛查的孕晚期孕 异常者；（3）合并恶性肿瘤者。
妇 11 248 例作为研究对象，年龄 20~47 岁，平均年龄 1.2 研究材料
（31.2±3.6）岁。按不同的采样和检测方法将研究对象 1.2.1 样本采集 GBS 采样分为两种方法：（1）单拭
分为单拭子 - 培养法组（n=4 479）、双拭子 - 培养法 子法，将无菌棉拭子先采集阴道分泌物样本后，同一支