Khalil Mohammed R, Uldbjerg Niels, Møller Jens K, Thorsen Poul B
a Department of Gynecology and Obstetrics , Lillebaelt Hospital , Kolding , Denmark.
b Department of Obstetrics and Gynecology , Aarhus University Hospital , Skejby , Denmark.
J Matern Fetal Neonatal Med. 2019 Oct;32(19):3176-3184. doi: 10.1080/14767058.2018.1459552. Epub 2018 Apr 12.
To investigate an association between Group B streptococci (GBS) in urine culture during pregnancy and preterm delivery. A population-based cohort consisted of all the pregnant women ( = 36,097) from the catchment area of Lillebaelt Hospital, Denmark, during the period January 2002 -December 2012. The cohort of 34,285 singleton pregnancies used in this study was divided into three groups. Group I ( = 249) included women whose urine culture was positive for GBS; group II ( = 5765) included women whose urine culture was negative for GBS; and group III ( = 28 271) included women whose urine had not been cultured during pregnancy. Primary outcome was preterm delivery before 37 weeks' gestation (PTD). We did not find an association between PTD and GBS bacteriuria in the cultured groups (odds ratios (OR) = 0.89; 95% CI: 0.5-1.4) ( Table 1 ). After controlling for potential confounders, the PTD remained not associated with GBS bacteriuria (adjusted OR = 0.99; 95% CI: 0.6-1.6). Combined, the cultured groups (I and II) were associated with a statistically significant higher risk for PTD, when compared with the group with no urine specimens taken for culture (OR = 1.96; 95% CI: 1.8-2.2 and adjusted or 1.80; 95% CI 1.6-2.0). The cultured group of women differed considerably from the group of women with no urine specimens taken for culture on the vast majority of variables examined. No association between asymptomatic GBS bacteriuria and preterm delivery among women with singleton pregnancy and urine specimens cultured during pregnancy was found. Previous suggestions of such association may have been compromised by a selection problem for testing due to a high-risk profile of pregnancy complications in pregnant women selected for urine culture.
调查孕期尿培养中B族链球菌（GBS）与早产之间的关联。一项基于人群的队列研究纳入了2002年1月至2012年12月期间丹麦利勒拜尔医院服务区域内的所有孕妇（n = 36,097）。本研究中使用的34,285例单胎妊娠队列被分为三组。第一组（n = 249）包括尿培养GBS阳性的女性；第二组（n = 5765）包括尿培养GBS阴性的女性；第三组（n = 28,271）包括孕期未进行尿培养的女性。主要结局是妊娠37周前的早产（PTD）。我们未在培养组中发现PTD与GBS菌尿之间存在关联（优势比（OR）= 0.89；95%置信区间：0.5 - 1.4）（表1）。在控制潜在混杂因素后，PTD仍与GBS菌尿无关（调整后OR = 0.99；95%置信区间：0.6 - 1.6）。综合来看，与未采集尿标本进行培养的组相比，培养组（第一组和第二组）发生PTD的风险在统计学上显著更高（OR = 1.96；95%置信区间：1.8 - 2.2，调整后OR为1.80；95%置信区间1.6 - 2.0）。在绝大多数检查的变量上，培养组女性与未采集尿标本进行培养的女性组有很大差异。在单胎妊娠且孕期进行尿标本培养的女性中，未发现无症状GBS菌尿与早产之间存在关联。先前关于这种关联（的研究）可能因选择进行检测的问题而受到影响，因为被选来进行尿培养的孕妇存在妊娠并发症的高风险特征。
