Stapleton Renee D, Kahn Jeremy M, Evans Laura E, Critchlow Cathy W, Gardella Carolyn M
Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA 98104, USA.
Obstet Gynecol. 2005 Dec;106(6):1246-52. doi: 10.1097/01.AOG.0000187893.52488.4b.
To identify risk factors for group B streptococcus (GBS) colonization in pregnancy, hypothesizing that health care workers may have increased risk.
Population-based, case-control study comparing 40,459 cases of GBS colonization, identified from Washington State birth certificate data linked to hospital discharge data for live births between 1997 and 2002, with 84,268 controls matched by year of delivery by multivariable logistic regression.
After adjustment for confounders, the following characteristics were independently associated with increased maternal GBS colonization: health care occupation (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.07-1.38), black race (OR 1.54, 95% CI 1.36-1.74), overweight (OR 1.07, 95% CI 1.01-1.12), obesity (OR 1.20, 95% CI 1.13-1.28), severe obesity (OR 1.45, 95% CI 1.28-1.63), median income greater than lowest quintile (OR 1.29, 95% CI 1.20-1.39 for fifth versus first quintile), some high school education (OR 1.21, 95% CI 1.05-1.40), high school graduate (OR 1.35, 95% CI 1.16-1.56), and adequate prenatal care (OR 1.14, 95% CI 1.06-1.24). Hispanic women (OR 0.88, 95% CI 0.80-0.96) and smokers (OR for 1-10 cigarettes per day 0.90, 95% CI 0.83-0.97) had a decreased odds of colonization.
Health care workers, black women, and women with high body mass index may be at greater risk of GBS colonization in pregnancy. However, any increases in risk are modest and the association between a health care occupation and GBS colonization needs to be investigated further.
确定孕期B族链球菌（GBS）定植的风险因素，推测医护人员可能有更高的风险。
基于人群的病例对照研究，比较了40459例GBS定植病例与84268例对照。GBS定植病例是从1997年至2002年与华盛顿州出生证明数据相链接的活产医院出院数据中识别出来的，对照则通过多变量逻辑回归按分娩年份进行匹配。
在对混杂因素进行调整后，以下特征与孕产妇GBS定植增加独立相关：医护职业（比值比[OR]1.22，95%置信区间[CI]1.07 - 1.38）、黑人种族（OR 1.54，95% CI 1.36 - 1.74）、超重（OR 1.07，95% CI 1.01 - 1.12）、肥胖（OR 1.20，95% CI 1.13 - 1.28）、重度肥胖（OR 1.45，95% CI 1.28 - 1.63）、收入中位数高于最低五分位数（第五分位数与第一分位数相比，OR 1.29，95% CI 1.20 - 1.39）、接受过一些高中教育（OR 1.21，95% CI 1.05 - 1.40）、高中毕业生（OR 1.35，95% CI 1.16 - 1.56）以及接受过充分的产前护理（OR 1.14，95% CI 1.06 - 1.24）。西班牙裔女性（OR 0.88，95% CI 0.80 - 0.96）和吸烟者（每天吸1 - 10支烟的OR 0.90，95% CI 0.83 - 0.97）定植的几率降低。
医护人员、黑人女性以及体重指数高的女性在孕期GBS定植的风险可能更高。然而，风险的任何增加都较为适度，医护职业与GBS定植之间的关联需要进一步研究。
