Meta-analysis on prevalence of vaginal group B streptococcus colonization and preterm births in India.

Preterm birth is a major cause of neonatal morbidity and mortality. Vaginal colonization of Group B Streptococci (GBS) is associated with increased risk of preterm birth. However, the association of GBS colonization and preterm births in the Indian context remains an unrecognized problem. Data was collected using various online search tools from 36 (1981-2019) Indian studies comprising 9778 cases. Studies reporting the prevalence of GBS colonization in the Indian population were included. The prevalence of GBS colonization in pregnant Indian women was estimated to be 7.8% (763/9778) with wide heterogeneity across studies. The prevalence of GBS was 7.4% when culture methods were used and 11.6% with use of immunological methods. The detection rate of GBS almost doubled when enrichment was used in the culture method (8.1 vs. 5%). The risk of preterm delivery was higher (OR 7.9) among women with GBS colonization as compared to those without GBS. As compared to the western population, there is low prevalence of GBS colonization among Indian pregnant women; however, the risk of preterm births with GBS colonization is higher. There is a need to implement a universal GBS screening program prior to intrapartum antibiotic prophylaxis in women experiencing preterm births.