Second Department of Obstetrics, The Fourth Hospital of Shijiazhuang, No.206, Zhongshan East Road, Chang'an District, Shijiazhuang, Hebei, People's Republic of China, 050011.
Perinatal center, The Fourth Hospital of Shijiazhuang, Shijiazhuang, Hebei, People's Republic of China, 050000.
BMC Pregnancy Childbirth. 2021 Mar 25;21(1):250. doi: 10.1186/s12884-021-03731-7.
Chorioamnionitis may cause serious perinatal and neonatal adverse outcomes, and group B streptococcus (GBS) is one of the most common bacteria isolated from human chorioamnionitis. The present study analyzed the impact of GBS infection and histological chorioamnionitis (HCA) on pregnancy outcomes and the diagnostic value of various biomarkers.
Pregnant women were grouped according to GBS infection and HCA detection. Perinatal and neonatal adverse outcomes were recorded with a follow-up period of 6 weeks. The white blood cell count (WBC), neutrophil ratio, and C-reactive protein (CRP) level from peripheral blood and soluble intercellular adhesion molecule-1 (sICAM-1), interleukin 8 (IL-8), and tumor necrosis factor α (TNF-α) levels from cord blood were assessed.
A total of 371 pregnant women were included. Pregnant women with GBS infection or HCA had a higher risk of pathological jaundice and premature rupture of membranes and higher levels of sICAM-1, IL-8, and TNF-α in umbilical cord blood. Univariate and multivariate regression analysis revealed that sICMA-1, IL-8, TNF-α, WBC, and CRP were significantly related to an increased HCA risk. For all included pregnant women, TNF-α had the largest receiver operating characteristic (ROC) area (area: 0.841; 95% CI: 0.778-0.904) of the biomarkers analyzed. TNF-α still had the largest area under the ROC curve (area: 0.898; 95% CI: 0.814-0.982) for non-GBS-infected pregnant women, who also exhibited a higher neutrophil ratio (area: 0.815; 95% CI: 0.645-0.985) and WBC (area: 0.849; 95% CI: 0.72-0.978), but all biomarkers had lower value in the diagnosis of HCA in GBS-infected pregnant women.
GBS infection and HCA correlated with several perinatal and neonatal adverse outcomes. TNF-α in cord blood and WBCs in peripheral blood had diagnostic value for HCA in non-GBS-infected pregnant women but not GBS-infected pregnant women.
绒毛膜羊膜炎可导致严重的围产期和新生儿不良结局，而 B 组链球菌（GBS）是从人类绒毛膜羊膜炎中分离出的最常见细菌之一。本研究分析了 GBS 感染和组织学绒毛膜羊膜炎（HCA）对妊娠结局的影响，以及各种生物标志物的诊断价值。
根据 GBS 感染和 HCA 检测结果将孕妇进行分组。通过 6 周的随访记录围产期和新生儿不良结局。检测外周血白细胞计数（WBC）、中性粒细胞比例和 C 反应蛋白（CRP）水平，以及脐血可溶性细胞间黏附分子-1（sICAM-1）、白细胞介素 8（IL-8）和肿瘤坏死因子 α（TNF-α）水平。
共纳入 371 例孕妇。GBS 感染或 HCA 的孕妇发生病理性黄疸和胎膜早破的风险较高，脐血中 sICAM-1、IL-8 和 TNF-α 水平也较高。单因素和多因素回归分析显示，sICMA-1、IL-8、TNF-α、WBC 和 CRP 与 HCA 风险增加显著相关。对于所有纳入的孕妇，TNF-α 是分析的生物标志物中 ROC 曲线下面积（AUC）最大的（AUC：0.841；95%CI：0.778-0.904）。对于未感染 GBS 的孕妇，TNF-α 仍具有最大的 ROC 曲线下面积（AUC：0.898；95%CI：0.814-0.982），且中性粒细胞比例（AUC：0.815；95%CI：0.645-0.985）和 WBC（AUC：0.849；95%CI：0.72-0.978）也较高，但所有生物标志物对 GBS 感染孕妇的 HCA 诊断价值较低。
GBS 感染和 HCA 与多种围产期和新生儿不良结局相关。未感染 GBS 的孕妇脐血中 TNF-α 和外周血中 WBC 对 HCA 具有诊断价值，但对 GBS 感染孕妇则无此价值。
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