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Invasive disease due to group B Streptococcus in pregnant women and neonates from diverse population groups
D F Zaleznik1, M A Rench, S Hillier
1Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Insights
Group B Streptococcus (GBS) caused invasive disease in newborns and pregnant women. Black or Hispanic race and low birth weight were linked to neonatal GBS, with serotypes Ia and III predominating.
Area of Science:
- Neonatal infections
- Obstetric infections
- Bacterial pathogenesis
Background:
- Group B Streptococcus (GBS) is a leading cause of invasive disease in neonates and pregnant women.
- Surveillance data on GBS incidence and risk factors are crucial for public health interventions.
- Understanding GBS serotype distribution aids in vaccine development and prevention strategies.
Purpose of the Study:
- To describe the epidemiology of invasive GBS disease in neonates and peripartum women in the United States.
- To identify risk factors associated with neonatal GBS infection.
- To characterize the serotype distribution of GBS isolates from invasive infections.
Main Methods:
- Prospective surveillance for invasive GBS disease in neonates (<7 days) and peripartum women.
- Data collected from a diverse cohort across four US cities from 1993-1996.
- Analysis of demographic factors, birth weight, and GBS serotypes.
Main Results:
- 130 neonatal (0.8/1000 births) and 54 maternal (0.3/1000) cases identified.
- Black or Hispanic race and birth weight <2500g were significant correlates of neonatal GBS.
- Serotypes Ia and III predominated (34-37% and 25-26%, respectively), with type V also frequent (14-23%).
Conclusions:
- Invasive GBS disease presented significant risks to neonates and peripartum women during 1993-1996.
- Risk factors for neonatal GBS include race and low birth weight.
- Predominant GBS serotypes Ia, III, and V inform prevention and vaccine efforts.
Abstract:
From 1993 through 1996, surveillance for invasive disease due to group B Streptococcus (GBS) in neonates aged <7 days and in peripartum pregnant women was performed in a racially and ethnically diverse cohort in 4 cities in the United States. In a birth population of 157,184, 130 neonatal cases (0.8 per 1000) and 54 maternal cases (0.3 per 1000) were identified. Significant correlates with neonatal disease were black or Hispanic race and a birth weight <2500 g. The attack rate for peripartum maternal infection varied widely by city and may have been influenced by the frequency of administration of intrapartum antibiotics or of evaluating febrile women by performance of blood cultures. Pregnancy loss or GBS disease in the infant occurred in 28% of these maternal cases. Among neonatal and maternal GBS isolates, serotypes Ia (34%-37%) and III (25%-26%) predominated, and type V was frequent (14%-23%). These results provide a description of invasive GBS perinatal infection during the period in which guidelines for prevention were actively disseminated.