Prevalence of Group B Streptococcus Colonization in Subsequent Pregnancies of Group B Streptococcus–Colonized versus Noncolonized Women
13 November 2011
24 May 2012
21 September 2012 (eFirst)
Objective To determine whether group B Streptococcus (GBS)-colonized pregnant women have an increased prevalence of GBS colonization in subsequent pregnancies.
Study Design This retrospective cohort study compared the prevalence of GBS colonization in initial and subsequent pregnancies of 158 women with two or more deliveries at a Midwest institution since the initiation of universal screening for GBS.
Results The GBS colonization rate in index pregnancies was 20%. Colonization rate in subsequent pregnancies for initially GBS-colonized women was 42% compared with 19% for women who were not colonized with GBS in the index pregnancy (p = 0.009). The relative risk for GBS-colonized women to be GBS-colonized in subsequent pregnancies was 2.2 (confidence interval = 1.3 to 3.8).
Conclusion Previous GBS colonization is a risk factor for GBS colonization in subsequent pregnancies. Consideration of intrapartum chemoprophylaxis in women with a history of GBS colonization, assuming current colonization status is unknown, warrants further investigation.
Presented at the Armed Forces District Meeting of the American College of Obstetricians and Gynecologists, Norfolk, VA, October 15, 2008
- 1 Schrag SD, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC. MMWR Recomm Rep 2002; 51 (RR-11) 1-22
- 2 Verani JR, McGee L, Schrag SJ. Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC). Prevention of perinatal group B streptococcal disease—revised guidelines from CDC, 2010. MMWR Recomm Rep 2010; 59 (RR-10) 1-36
- 3 Schrag SJ, Zywicki S, Farley MM , et al. Group B streptococcal disease in the era of intrapartum antibiotic prophylaxis. N Engl J Med 2000; 342: 15-20
- 4 Centers for Disease Control and Prevention. Prevention of perinatal group B streptococcal disease: a public health perspective. MMWR Recomm Rep 1996; 45 (RR-7) 1-24
- 5 Schuchat A, Deaver-Robinson K, Plikaytis BD, Zangwill KM, Mohle-Boetani J, Wenger JD. Multistate case-control study of maternal risk factors for neonatal group B streptococcal disease. The Active Surveillance Study Group. Pediatr Infect Dis J 1994; 13 (7) 623-629
- 6 Regan JA, Klebanoff MA, Nugent RP. Vaginal Infections and Prematurity Study Group. The epidemiology of group B streptococcal colonization in pregnancy. Obstet Gynecol 1991; 77: 604-610
- 7 Persson K, Bjerre B, Elfström L, Forsgren A. Longitudinal study of group B streptococcal carriage during late pregnancy. Scand J Infect Dis 1987; 19: 325-329
- 8 Chung MY, Ko DJ, Chen CC , et al. Neonatal group B streptococcal infection: a 7-year experience. Chang Gung Med J 2004; 27: 501-508
- 9 Cheng PJ, Chueh HY, Liu CM, Hsu JJ, Hsieh TT, Soong YK. Risk factors for recurrence of group B streptococcus colonization in a subsequent pregnancy. Obstet Gynecol 2008; 111: 704-709
- 10 Turrentine MA, Ramirez MM. Recurrence of group B streptococci colonization in subsequent pregnancy. Obstet Gynecol 2008; 112 (2 Pt 1) 259-264
- 11 Stoll BJ, Schuchat A. Maternal carriage of group B streptococci in developing countries. Pediatr Infect Dis J 1998; 17: 499-503
- 12 de Steenwinkel FD, Tak HV, Muller AE, Nouwen JL, Oostvogel PM, Mocumbi SM. Low carriage rate of group B streptococcus in pregnant women in Maputo, Mozambique. Trop Med Int Health 2008; 13: 427-429
- 13 American College of Obstetricians and Gynecologists. Committee Opinion: number 485, April 2011. Prevention of early-onset group B streptococcal disease in newborns. Obstet Gynecol 2011; 117 (4) 1405-1412
- 14 Schuchat A, Oxtoby M, Cochi S , et al. Population-based risk factors for neonatal group B streptococcal disease: results of a cohort study in metropolitan Atlanta. J Infect Dis 1990; 162: 672-677
- 15 Zaleznik DF, Rench MA, Hillier S , et al. Invasive disease due to group B Streptococcus in pregnant women and neonates from diverse population groups. Clin Infect Dis 2000; 30: 276-281
- 16 Boyer KM, Gadzala CA, Burd LI, Fisher DE, Paton JB, Gotoff SP. Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. I. Epidemiologic rationale. J Infect Dis 1983; 148: 795-801
- 17 Daimaru-Enoki LC, Morgan M, Nichols WS, Silverman NS. First-trimester group B Streptococcus colonization of the cervix: a risk factor for maternal colonization at term?. J Reprod Med 2005; 50: 496-500
- 18 Rodriguez E, Raker CA, Paglia MJ, Anderson BL. Compliance with group B streptococcus testing prior to labor and delivery. Am J Perinatol 2010; 27: 475-479
- 19 Goins WP, Talbot TR, Schaffner W , et al. Adherence to perinatal group B streptococcal prevention guidelines. Obstet Gynecol 2010; 115: 1217-1224