通过在 35-37 孕周时增加 GBS 尿筛查，改进分娩时聚合酶链反应筛查阴道型 B 组链球菌（GBS）定植的孕妇选择。
Improvement of selection of pregnant women for intrapartum polymerase chain reaction screening for vaginal Group B Streptococci (GBS) colonization by adding GBS urine screening at 35-37 weeks of pregnancy.
机构信息
Department of Gynecology and Obstetrics, University Hospital of Southern Denmark, Lillebaelt Hospital, Kolding, Denmark.
Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
出版信息
Int J Gynaecol Obstet. 2020 Oct;151(1):124-127. doi: 10.1002/ijgo.13267. Epub 2020 Jul 9.
OBJECTIVE
To evaluate whether systematic antepartum screening for Group B Streptococci (GBS) by urine culture improves the risk factor-based selection of pregnant women for intrapartum GBS screening with a rapid polymerase chain reaction (PCR) assay.
METHODS
A prospective observational study was conducted between April 2013 and June 2014. GBS colonization judged by urine culture at 35-37 weeks of gestation was compared with the result of a vaginal GBS PCR test at labor as outcome. The results of urine culture were used as exposure variable. The PCR test was performed on intrapartum vaginal samples.
RESULTS
Screening for urine GBS in 902 unselected pregnant Danish women at 35-37 weeks of gestation predicted intrapartum PCR GBS status with a sensitivity of 33.6%. A positive predictive value of 41.2% was seen among women with low GBS counts (<104 CFU/mL) and 83.3% among women with high GBS counts (≥104 CFU/mL). Systematic GBS screening of urine at 35-37 weeks of gestation added 30.9% extra women for intrapartum GBS PCR screening in the study group.
CONCLUSION
Systematic antepartum GBS screening of urine should be implemented in order to improve risk stratification for early onset GBS by offering laboring women an intrapartum GBS PCR test.
目的
评估通过尿培养进行系统的产前 B 组链球菌（GBS）筛查是否能改善基于风险因素的孕妇选择，以便用快速聚合酶链反应（PCR）检测进行产时 GBS 筛查。
方法
这是一项前瞻性观察研究，于 2013 年 4 月至 2014 年 6 月进行。将妊娠 35-37 周时通过尿培养判断的 GBS 定植与分娩时阴道 GBS PCR 检测结果进行比较作为结局。尿培养结果作为暴露变量。PCR 检测在产时阴道样本上进行。
结果
在 902 名未经选择的丹麦孕妇中，在妊娠 35-37 周时筛查尿 GBS，对产时 PCR GBS 状态的敏感性为 33.6%。在 GBS 计数较低（<104 CFU/mL）的女性中，阳性预测值为 41.2%，在 GBS 计数较高（≥104 CFU/mL）的女性中，阳性预测值为 83.3%。在研究组中，系统的 35-37 周产前尿 GBS 筛查增加了 30.9%的女性进行产时 GBS PCR 筛查。
结论
为了通过提供产时 GBS PCR 检测来改善早发型 GBS 的风险分层，应实施系统的产前 GBS 尿筛查。
Zotero 插件