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A Murine Model of Group B Streptococcus Vaginal Colonization
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Is Group B Streptococcus Colonization Associated with Maternal Peripartum Infection in an Era of Routine Prophylaxis?

Kartik K Venkatesh1, Catherine J Vladutiu1, Angelica V Glover1

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.

American Journal of Perinatology
|May 24, 2020
PubMed
Summary

Maternal group B streptococcus (GBS) colonization is linked to reduced chorioamnionitis risk during routine prophylaxis. This contrasts with older data, suggesting benefits beyond neonatal protection.

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Area of Science:

  • Obstetrics and Gynecology
  • Infectious Diseases
  • Maternal Health

Background:

  • Historically, maternal group B streptococcus (GBS) colonization correlated with increased peripartum infection risk.
  • Routine GBS screening and intrapartum antibiotic prophylaxis are standard practices in many regions.
  • The impact of GBS colonization on maternal infection in the current prophylaxis era requires updated assessment.

Purpose of the Study:

  • To evaluate the association between maternal GBS colonization and peripartum infection in the context of routine prophylaxis.
  • To determine if GBS colonization influences the risk of chorioamnionitis and postpartum infections.
  • To explore potential benefits of GBS screening and prophylaxis for maternal infectious morbidity.

Main Methods:

  • Secondary analysis of the U.S. Consortium on Safe Labor (CSL) study data.
  • Inclusion criteria: women delivering at ≥37 weeks gestation.
  • Logistic regression with generalized estimating equations was used to analyze GBS colonization (exposure) and chorioamnionitis/postpartum infections (outcomes), adjusting for multiple covariates.

Main Results:

  • Among 170,804 women, 19.8% were GBS colonized; 3.0% had chorioamnionitis.
  • GBS colonization was associated with a statistically significant lower odds of chorioamnionitis (aOR: 0.89; 95% CI: 0.83-0.96).
  • No increased odds of postpartum infectious outcomes were observed with GBS colonization.

Conclusions:

  • Maternal GBS colonization is associated with reduced odds of chorioamnionitis in the era of routine screening and prophylaxis.
  • These findings suggest that GBS screening and prophylaxis may offer maternal benefits beyond preventing neonatal infections.
  • The study highlights a shift from historical data, indicating potential protective effects of GBS management on maternal infectious morbidity.