Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study.

Edwards, James M

Watson, Nora

Focht, Chris

Wynn, Clara

Todd, Christopher A

Walter, Emmanuel B

Heine, R Phillips

Swamy, Geeta K

2019-04-01T16:50:13Z

2019-04-01T16:50:13Z

2019-01

2019-04-01T16:50:10Z

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.

1064-7449

1098-0997

https://hdl.handle.net/10161/18200

eng

Hindawi Limited

Infectious diseases in obstetrics and gynecology

10.1155/2019/5430493

Group B Streptococcus (GBS) Colonization and Disease among Pregnant Women: A Historical Cohort Study.

Journal article

Swamy, Geeta K|0000-0001-5092-6993

5430493

School of Medicine

Duke

Duke Human Vaccine Institute

Institutes and Centers

Duke Clinical Research Institute

Pediatrics, Primary Care Pediatrics

Pediatrics

Clinical Science Departments

Published

2019