妊娠期糖尿病与B族链球菌感染的关联性

doi:10.3969/j.issn.1006-5725.2026.02.021

Abstract

Abstract:

Objective To clarify the clinical characteristics of patients with gestational diabetes mellitus （GDM） complicated by group B streptococcus （GBS） infection and its impact on pregnancy outcomes， and to analyze the predictive value of glycated hemoglobin （HbA_1c）， neutrophil-to-lymphocyte ratio （NLR）， and platelet-to-lymphocyte ratio （PLR） in GDM patients complicated by GBS infection and its complication， chorioamnionitis. Methods A retrospective selection was conducted on 277 inpatients diagnosed with GDM who were admitted to the NanhaiMaternal and Child Health Hospital， Foshan City from January 2023 to December 2024. Among these patients， those with GDM combined with GBS infection were assigned to the positive group （n = 75）， while those with GDM but without GBS infection were assigned to the control group （n = 202）. The differences in clinical data， including age， and pregnancy outcomes between the two groups of pregnant women were compared. Multivariate logistic regression analysis was employed to explore the risk factors for GBS infection in GDM patients and the risk factors for chorioamnionitis in GDM patients with GBS infection. The predictive value of the relevant indicators was assessed using the receiver operating characteristic curve （ROC）. Results In the positive group， the levels of HbA_1c， NLR， and PLR were significantly elevated. Moreover， the incidences of premature rupture of membranes and intrauterine distress also showed a significant increase， and these differences were statistically significant （all P < 0.05）. The results of multivariate logistic regression analysis indicated that HbA1c （OR = 2.574， 95%CI： 1.355 ~ 4.889） and NLR （OR = 1.545， 95%CI： 1.318 ~ 1.811） were independent risk factors for GBS infection in patients with GDM （all P < 0.05）. Meanwhile， NLR （OR = 1.694， 95%CI： 1.242 ~ 2.190） was identified as an independent risk factor for chorioamnionitis in GDM patients with GBS infection. The ROC curve results demonstrated that the area under the curve （AUC） of the combined prediction model constructed based on HbA_1c and NLR for predicting GBS infection in GDM patients was 0.800 （95%CI： 0.741 ~ 0.859）， and the AUC of NLR for predicting chorioamnionitis was 0.855 （95%CI： 0.760 ~ 0.951）. The PLR had no significant correlation with GBS infection and its complications （P > 0.05）. Conclusions GBS infection in patients with GDM elevates the risk of adverse pregnancy outcomes among pregnant women. Elevated levels of glycated HbA_1c and NLR are independent risk factors for GBS infection in GDM patients. The NLR holds predictive value for chorioamnionitis in GDM patients with GBS infection. It is advisable to enhance the management of high-risk pregnancies to prevent adverse pregnancy outcomes and mitigate the risk of maternal and infant infections during the perinatal period.

Key words: gestational diabetes mellitus, group b streptococcus, pregnancy outcome, neutrophil-to-lymphocyte ratio, glyc-ated hemoglobin, chorioamnionitis

CLC Number:

R714.256

Liuhua HUANG,Ning ZHOU,Zicong ZHOU,Qinghua WU,Weiwei XIAO,Chenguang SHEN,Li ZHU,Wei ZHAO. A study on the association between gestational diabetes mellitus and group B streptococcus infection[J]. The Journal of Practical Medicine, 2026, 42(2): 342-347.

Figures/Tables 5

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References 22

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项目	阴性组（n = 202）	阳性组（n = 75）	t/χ²/Z值	P值
年龄（x ± s）/岁	31.38 ± 4.629	31.79 ± 4.729	-0.644	0.520
孕前BMI（x ± s）/（kg/m²）	22.32 ± 3.421	22.79 ± 3.205	-1.023	0.307
有无流产史			0.490	0.484
无	109（53.96）	44（58.67）
有	93（46.04）	31（41.33）
产次			0.790	0.374
初产	77（38.12）	33（44.00）
经产	125（61.88）	42（56.00）
OGTT（x ± s）/（mmol/L）
空腹	4.82 ± 0.734	4.82 ± 0.566	-0.003	0.998
服糖后1 h	10.27 ± 1.680	10.11 ± 1.658	0.675	0.500
服糖后2 h	8.90 ± 1.568	8.78 ± 1.570	0.569	0.570
HbA_1c（x ± s）/%	5.27 ± 0.459	5.47 ± 0.471	-3.283	0.001
NLR[M（P₂₅，P₇₅）]	3.88（2.990，4.910）	5.87（4.460，7.605）	-7.294	< 0.001
PLR（x ± s）	136.11 ± 45.271	161.45 ± 50.511	-4.009	< 0.001
胎膜早破			4.936	0.026
无	149（73.76）	45（60.00）
有	53（26.24）	30（40.00）
宫内窘迫			9.375	0.002
无	184（91.09）	58（77.33）
有	18（8.91）	17（22.67）
初产者分娩方式			1.050	0.591
顺产	102（50.50）	39（52.00）
剖宫产	94（46.53）	32（42.67）
产钳助产	6（2.97）	4（5.33）
新生儿体质量（x ± s）/kg	3.00 ± 0.512	3.03 ± 0.462	-0.376	0.707

项目	B	SE	Wald	P值	OR	95%CI
NLR	0.435	0.081	28.720	< 0.001	1.545	1.318 ~ 1.811
HbA_1c	0.945	0.327	8.338	0.004	2.574	1.355 ~ 4.889
PLR	0.002	0.004	0.348	0.555	1.002	0.995 ~ 1.009

项目	B	SE	Wald	P值	OR	95%CI
NLR	0.500	0.145	11.944	0.001	1.649	1.242 ~ 2.190
HbA_1c	-0.865	0.719	1.448	0.229	0.421	0.103 ~ 1.723
PLR	0.001	0.006	0.013	0.909	1.001	0.988 ~ 1.013

A study on the association between gestational diabetes mellitus and group B streptococcus infection

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