Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study.
Journal
Infectious diseases in obstetrics and gynecology
ISSN: 1098-0997
Titre abrégé: Infect Dis Obstet Gynecol
Pays: Egypt
ID NLM: 9318481
Informations de publication
Date de publication:
2019
2019
Historique:
received:
25
09
2018
revised:
28
11
2018
accepted:
01
01
2019
entrez:
12
3
2019
pubmed:
12
3
2019
medline:
10
7
2019
Statut:
epublish
Résumé
Maternal GBS colonization is associated with early-onset neonatal sepsis and extensive efforts are directed to preventing this complication. Less is known about maternal risks of GBS colonization. We seek to provide a modern estimate of the incidence and impact of maternal GBS colonization and invasive GBS disease. A single center historical cohort study of all births between 2003 and 2015 was performed. Data was collected via electronic health record abstraction using an institutional specific tool. Descriptive statistics were performed regarding GBS status. Inferential statistics were performed comparing risk of adverse pregnancy outcomes in cohorts with and without GBS colonization as well as cohorts with GBS colonization and invasive GBS disease. A total of 60,029 deliveries were included for analysis. Overall, 21.6% of the population was GBS colonized and 0.1% had invasive GBS disease. GBS colonization was associated with younger maternal age, Black race, non-Hispanic ethnicity, chronic hypertension, preexisting diabetes, and tobacco use (p<0.01). In the adjusted analyses, there was an increased risk of gestational diabetes (aRR 1.21, 95% CI 1.11-1.32) in colonized pregnancies and a decreased incidence of short cervix (aRR 0.64, 95% CI 0.52-0.79), chorioamnionitis (aRR 0.76, 95% CI 0.66-0.87), wound infection (aRR 0.75, 95% CI 0.64-0.88), and operative delivery (aRR 0.85, 95% CI 0.83-0.88). This modern-day large cohort of all births over a 12-year period demonstrates a GBS colonization rate of 21.6%. This data reflects a need to assess maternal and perinatal outcomes in addition to neonatal GBS sepsis rates to inform decisions regarding the utility of maternal vaccination.
Sections du résumé
Background
Maternal GBS colonization is associated with early-onset neonatal sepsis and extensive efforts are directed to preventing this complication. Less is known about maternal risks of GBS colonization. We seek to provide a modern estimate of the incidence and impact of maternal GBS colonization and invasive GBS disease.
Methods
A single center historical cohort study of all births between 2003 and 2015 was performed. Data was collected via electronic health record abstraction using an institutional specific tool. Descriptive statistics were performed regarding GBS status. Inferential statistics were performed comparing risk of adverse pregnancy outcomes in cohorts with and without GBS colonization as well as cohorts with GBS colonization and invasive GBS disease.
Results
A total of 60,029 deliveries were included for analysis. Overall, 21.6% of the population was GBS colonized and 0.1% had invasive GBS disease. GBS colonization was associated with younger maternal age, Black race, non-Hispanic ethnicity, chronic hypertension, preexisting diabetes, and tobacco use (p<0.01). In the adjusted analyses, there was an increased risk of gestational diabetes (aRR 1.21, 95% CI 1.11-1.32) in colonized pregnancies and a decreased incidence of short cervix (aRR 0.64, 95% CI 0.52-0.79), chorioamnionitis (aRR 0.76, 95% CI 0.66-0.87), wound infection (aRR 0.75, 95% CI 0.64-0.88), and operative delivery (aRR 0.85, 95% CI 0.83-0.88).
Conclusions
This modern-day large cohort of all births over a 12-year period demonstrates a GBS colonization rate of 21.6%. This data reflects a need to assess maternal and perinatal outcomes in addition to neonatal GBS sepsis rates to inform decisions regarding the utility of maternal vaccination.
Identifiants
pubmed: 30853787
doi: 10.1155/2019/5430493
pmc: PMC6378061
doi:
Types de publication
Historical Article
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
5430493Subventions
Organisme : NIAID NIH HHS
ID : HHSN272201300017C
Pays : United States
Organisme : NIAID NIH HHS
ID : HHSN272201300017I
Pays : United States
Références
Clin Infect Dis. 2017 Nov 6;65(suppl_2):S112-S124
pubmed: 29117328
Vaccine. 2013 Aug 28;31 Suppl 4:D52-7
pubmed: 23973347
Obstet Gynecol Clin North Am. 2014 Dec;41(4):629-47
pubmed: 25454995
Obstet Gynecol. 1994 Nov;84(5):816-9
pubmed: 7936518
J Biomed Inform. 2014 Dec;52:231-42
pubmed: 25051403
Obstet Gynecol. 2011 Apr;117(4):1019-27
pubmed: 21422882
Am J Epidemiol. 2004 Apr 1;159(7):702-6
pubmed: 15033648
Obstet Gynecol. 2013 Apr;121(4):812-8
pubmed: 23635682
Obstet Gynecol. 1999 Feb;93(2):292-6
pubmed: 9932572
Obstet Gynecol. 2016 Feb;127(2):213-21
pubmed: 26942345
Clin Perinatol. 2010 Jun;37(2):339-54
pubmed: 20569811
Acta Obstet Gynecol Scand. 2006;85(9):1027-37
pubmed: 16929406
Am J Obstet Gynecol. 1982 Apr 15;142(8):992-5
pubmed: 7041653
Am J Obstet Gynecol. 2004 Jul;191(1):211-6
pubmed: 15295368
Obstet Gynecol. 2018 Feb;131(2):328-335
pubmed: 29324613
Vaccine. 2014 May 30;32(26):3128-32
pubmed: 24736004
Ann Intern Med. 2007 Oct 16;147(8):573-7
pubmed: 17938396
BMC Pregnancy Childbirth. 2016 Nov 8;16(1):344
pubmed: 27825315
J Reprod Immunol. 2016 Jun;115:1-5
pubmed: 27061480
Clin Infect Dis. 2017 Nov 6;65(suppl_2):S200-S219
pubmed: 29117332
J Perinatol. 2003 Dec;23(8):691-2
pubmed: 14647171
J Reprod Med. 1989 Oct;34(10):797-801
pubmed: 2677355
J Infect Dis. 1999 Jun;179(6):1410-5
pubmed: 10228062