Maternal recto vaginal colonization in term and preterm deliveries

Maternal recto-vaginal organisms are the main cause of early-onset sepsis in neonates. The aim of this study was to determine the most common organisms and compare maternal recto-vaginal colonization in term and preterm delivery.

This cross-sectional study was done from October 2014 through October 2016 among participants referred to Ayatollah Rouhani Hospital in Babol, Northern Iran. All pregnant women within gestational age (GA) ≥ 26 weeks and labor pain were included in this study. By a cotton applicator, culture from the lower third of the vagina and another one from the rectum were taken and transported by Stuart media to the laboratory, and were cultured on main Medias within 24 hours. Then microorganisms in preterm and term delivery were compared together. Data were analyzed using SPSS 16. The variables were compared between two groups by chi-squared test, Fisher's exact test and logistic regression. P<0.05 was statistically considered significant.

Among 511 mothers with successful culturing, 417 delivered at term and 94 fewer than 37 weeks. Staphylococcus epidermidis and Escherichia coli (E. coli) were the most abundant organisms. The frequency of E. coli in term and preterm delivery was 52.5% and 68.1% respectively (p=0.006). Group B strep was more frequent in term delivery (13.7% vs. 3.2%, p=0.004).

Based on our findings, the frequency E. coli and other gram-negative bacteria were higher in preterm delivery groups which indicates the need to assess the efficacy of chemoprophylaxis in situations such as prolonged rupture of membrane, and preterm delivery.