Abstract：Objective: To establish the individual nomograms for predicting the risk of GBS infection model by analysis of risk factors related to the infection of Streptococcus lactis (GBS) in pregnant women in late pregnancy. Methods: From Jan 2017 to June 2017, 694 late pregnancy women were enrolled in this study. Their clinical data were analyzed and logistic regression model was used to determine the risk factors related to GBS infection. Then the R software was used to establish a predictive nomogram model of GBS infection. Bootstrap method was used to validate the nomogram model and ROC curve was used to explore the predictive efficacy of the model in predicting the GBS infection. Results: A total of 68 cases out of 694 cases had GBS infection. The prevalence rate was 9.80%. Age (OR=2.79,95CI%:1.45-5.39), overweight before pregnancy/obesity (R=2.50,95CI%:1.11-5.66), vaginitis (OR=3.71, 95CI%:1.88-7.32), urinary tract infection (OR=2.68, 95CI%:1.25-5.78), and pregnancy with diabetes mellitus (OR=3.14, 95CI%:1.39-7.09) were all independent risk factors for GBS infection (P<0.05). The nomogram model had a C-index of 0.816 with good discrimination and accuracy, and ROC curve showed that the area under the curve (AUC) for the nomogram model predicting GBS infection was 0.832 (95%CI: 0.757-0.899). Conclusion: The nomogram built based on age, overweight before pregnancy/obesity, vaginitis, urinary tract infection, and pregnancy with diabetes mellitus has a good discrimination and accuracy which could be helpful for screening the pregnancy women with high risk and setting the interventional plans.
曾宪琴, 王丽俊, 鲁炳怀. 个体化预测妊娠晚期孕妇无乳链球菌感染风险的列线图模型的建立[J]. 河北医学, 2018, 24(2): 296-301.
ZENG Xianqin, WANG Lijun, LU Binghuai. The Establishment of a Nomogram Model of no Streptococcus Infection Risk of Individual Prediction of Pregnant Women in Late Pregnancy. HeBei Med, 2018, 24(2): 296-301.
[1] 朱敏,范建霞,程利南.围产期B族链球菌感染的研究进展[J].中华妇产科杂志,2005,40(2):137~141. [2] 陈红波,孟祥莲,王谢桐.围生期B族链球菌感染的研究现状[J].现代妇产科进展,2015(2):149~151. [3] 仉英,应春妹.B族链球菌检测在围产期孕妇感染诊断中的意义[J].中华检验医学杂志,2016,39(6):410~412. [4] 李洪英,沈亚娟,余俊峰,等.妊娠期妇女B族链球菌感染对母儿预后影响的研究[J].中国实用妇科与产科杂志,2017,33(08):850~852. [5] 李凡,徐志凯.医学微生物学[M].第8版.人民卫生出版社,2013. [6] 杨慧霞.妊娠合并糖尿病临床诊断与治疗推荐指南(草案)[J].中国实用妇科与产科杂志,2007,6(6):310~312. [7] Cagno CK, Pettit JM, Weiss BD. Prevention of perinatal group B streptococcal disease: updated CDC guideline[J]. Am Fam Physician, 2012, 86(1):59~65. [8] 张淑珍,金卓杏,陈晓方,等.晚期妊娠孕妇B族链球菌感染状况及妊娠结局分析[J].中华医院感染学杂志,2017,27(12):2801~2804. [9] 王茜,马良坤,宋英娜,等.妊娠晚期B族链球菌感染的筛查方法及妊娠结局分析[J].中华医学杂志,2016,96(15):1188~1191. [10] 严静静,龚敏,张军,等.生殖道B群链球菌感染与胎膜早破的关系[J].中华医学杂志,2016,96(23):1847~1849. [11] 陶立元,张华,赵一鸣.列线图的制作要点及其应用[J].中华儿科杂志,2017,55(5):323. [12] Lu H, Pan J, Dan W, et al. Risk factors and nomogram for pancreatic pseudocysts in chronic pancreatitis: A cohort of 1998 patients[J].Gastroenterol Hepatol, 2017, 32(7):1403~1411. [13] 田晓文,梁小波,王振华,等.胃肠道间质瘤术后复发危险因素及列线图的应用价值[J].中华消化外科杂志,2017,16(1):71~76. [14] Li W, Li Y, Zhang Z, et al. Predictive nomogram of RAGE genetic polymorphisms and metabolic risk factors for myocardial infarction risk in a han Chinese population[J]. Angiology, 2017, 68(10):877~883. [15] 龚明霞,杜丹,潘东娜.妊娠晚期孕妇B族链球菌带菌危险因素及对妊娠结局的影响[J].中国妇幼保健,2017,32(13):2902~2904. [16] 张兰,朱樱梅,李敏许.妊娠期B族链球菌感染的高危因素及其对新生儿预后影响分析[J].中国妇幼健康研究,2017,28(6):731~733. [17] Lamas O, Marti A, Martinez J A. Obesity and immunocompetence[J]. Eur Clin Nutr, 2002, 56 Suppl 3(8):S42~45. [18] 张凌云,王占辉,张敏.妊娠期需氧菌性阴道炎与母婴B族链球菌感染的相关性研究[J].中华实验和临床感染病杂志:电子版,2015,9(2):253~255. [19] 朱一麟,高雪梅,贺漪.糖尿病患者高龄妊娠期生殖道感染的病原体分析[J].中华医院感染学杂志,2015,25(17):4033~4035. [20] 朱燕飞,王银雪,施美华,等.妊娠晚期孕妇B群溶血性链球菌携带状况及影响因素分析[J].预防医学,2017,29(03):304~305.
2018, Vol. 24 
冀公网安备13080202000677号