Khalil Mohammed R, Hartvigsen Camilla M, Thorsen Poul B, Møller Jens K, Uldbjerg Niels
Department of Obstetrics and Gynecology, Lillebaelt Hospital, Kolding, Denmark.
Department of Obstetrics and Gynecology, Aabenraa Hospital, Aabenraa, Denmark.
Int J Gynaecol Obstet. 2023 Apr;161(1):303-307. doi: 10.1002/ijgo.14449. Epub 2022 Sep 26.
To examine the effect of including maternal age and body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) as additional risk factors in the traditional risk-based strategy at term pregnancies consisting of previous early-onset group B streptococcus (GBS) disease, GBS bacteriuria during pregnancy, maternal temperature of 38.0°C or more intrapartum, and rupture of membranes of 18 h or longer.
A secondary analysis of a Danish cohort including 902 pregnant women. Exposures were maternal age and pre-pregnancy BMI. Outcome was rectovaginal GBS colonization at the time of labor. The logistic regression analysis adjusted for parity, gestational age, vaginal delivery, and smoking.
The GBS prevalence was 17% in the entire population, 35% among participants older than 40 years, and 23% among those with a BMI of 25 or greater. Including maternal "age > 40" as an additional risk factor increased the sensitivity of the risk-based strategy from 21% to 26% and decreased the specificity from 90% to 87%. Inclusion of "BMI ≥ 25" increased the sensitivity from 21% to 57% and decreased the specificity from 90% to 59%.
Maternal age and BMI might be included as additional risk factors in risk-based programs for identification of GBS-positive laboring women to receive intrapartum antibiotics prophylaxis.
探讨将孕妇年龄和体重指数（BMI；计算方法为体重千克数除以身高米数的平方）作为附加风险因素纳入传统基于风险的策略中，该策略用于足月妊娠，包括既往早发型B族链球菌（GBS）疾病、孕期GBS菌尿、产时孕妇体温38.0°C或更高以及胎膜破裂18小时或更长时间。
对一个包含902名孕妇的丹麦队列进行二次分析。暴露因素为孕妇年龄和孕前BMI。结局为分娩时直肠阴道GBS定植情况。逻辑回归分析对产次、孕周、阴道分娩和吸烟进行了校正。
整个人群中GBS患病率为17%，40岁以上参与者中为35%，BMI为25或更高者中为23%。将“年龄>40岁”作为附加风险因素纳入后，基于风险的策略的敏感性从21%提高到26%，特异性从90%降低到87%。纳入“BMI≥25”后，敏感性从21%提高到57%，特异性从90%降低到59%。
孕妇年龄和BMI可作为附加风险因素纳入基于风险的项目中，以识别GBS阳性的分娩妇女，使其接受产时抗生素预防。
