Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study.
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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.
Published Version (Please cite this version)10.1155/2019/5430493
Publication InfoSwamy, Geeta; Walter, Emmanuel; Edwards, James M; Watson, Nora; Focht, Chris; Wynn, Clara; ... Heine, R Phillips (2019). Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study. Infectious diseases in obstetrics and gynecology, 2019. pp. 5430493. 10.1155/2019/5430493. Retrieved from https://hdl.handle.net/10161/18200.
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Associate Professor of Obstetrics and Gynecology
Dr. Geeta Swamy, MD, became Vice Chair for Research and Faculty Development in the Department of Obstetrics and Gynecology on March 1, 2018. In this dual role, Dr. Swamy oversees strategic development and administration of the Department’s basic, translational and clinical research programs, as well as implements and oversees programs to support development and mentorship for all faculty at all levels. Dr. Swamy has dedicated her career to advancing research in women’s he
Professor of Pediatrics
Dr. Emmanuel (Chip) Walter is Director of the Duke Vaccine and Trials Unit Immunization research: 1) Phase 1, 2 and 3 vaccine trials including: pandemic and seasonal influenza virus vaccines, respiratory virus vaccines, rotavirus vaccine, human papilloma virus vaccine, conjugate pneumococcal vaccine, meningococcal vaccines, vaccines for biodefence; vaccines for emerging pathogens; combination vaccines; and vaccines containing novel adjuvants or usin
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