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Infectious Diseases in Obstetrics and Gynecology
Volume 2019, Article ID 5430493, 6 pages
https://doi.org/10.1155/2019/5430493
Research Article

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

1Maternal Fetal Medicine, WakeMed Health and Hospitals, Raleigh, NC, USA
2Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA
3The Emmes Corporation, Rockville, MD, USA
4Duke Human Vaccine Institute, Duke University Medical Center, Durham, NC, USA
5Department of Pediatrics, Duke University Medical Center, Durham, NC, USA

Correspondence should be addressed to James M. Edwards; gro.demekaw@sdrawdemaj and Geeta K. Swamy; ude.ekud@ymaws.ateeg

Received 25 September 2018; Revised 28 November 2018; Accepted 1 January 2019; Published 3 February 2019

Academic Editor: Bryan Larsen

Copyright © 2019 James M. Edwards et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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.