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Abstract
Objective
This study examines whether maternal group B Streptococcus (Streptococcus agalactiae, GBS) infection was associated with preterm births and premature neonatal outcomes.
Methods
Maternal and neonatal outcomes were examined among singleton pregnant women with preterm birth (from 24+0 weeks to 36+6 weeks) who were tested for GBS (n=203) during the pregnancy. Data were collected retrospectively from the medical records of women who delivered at our hospital from January 2015 to February 2017. We compared obstetrical factors (causes of preterm birth) and neonatal (gestational age at delivery, birth weight, Apgar score 1 min/5 min, hospitalization period, duration of mechanical ventilation, neonatal C-reactive protein within three days, and other complication [respiratory distress syndrome, neonatal deaths]) outcomes between GBS-infected and non-infected pregnant women.
Results
There were 203 singleton pregnant women included in the study, 25 of whom were confirmed to have a GBS infection during the pregnancy. There was no difference in neonatal outcomes by GBS status. Preterm premature rupture of membranes (pPROM), as an obstetric factor, was associated with GBS infection (P=0.022). GBS infection raised the risk of pPROM by 3.6 times (odds ratio 3.648, 95% confidence interval 1.476-9.016, P=0.005).
REFERENCES
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Table 1.
Study Subject Characteristics (n=203)
| GBS (+) (n=25, 12.3%) | GBS (−) (n=178, 87.7%) | P-value | |
|---|---|---|---|
| Maternal age (years) | 32.6±4.6 | 33.0±4.9 | 0.300∗ |
| STD infection (%) | 4 (9.5) | 38 (90.5) | 0.610† |
| Chorioamnionitis (%) | 8 (15.1) | 45 (84.9) | 0.675† |
| Maternal CRP | 1.21±2.65 | 1.31±3.09 | 0.389∗ |
| Maternal WBC | 11,125±3,581 | 10,923±3,581 | 0.445∗ |
Table 2.
Obstetric Factors between GBS (+) and GBS (-) in Preterm Birth
| GBS (+) (n=25, 12.3%) | GBS (−) (n=178, 87.7%) | P-value∗ | |
|---|---|---|---|
| Causes of preterm birth (%) | |||
| SPTL | 2 (8.0) | 64 (36.0) | 0.005 |
| pPROM | 14 (56.0) | 54 (30.3) | 0.022 |
| IIOC | 1 (4.0) | 6 (3.4) | 1.000 |
| Maternal complications† | 7 (28.0) | 44 (24.7) | 0.806 |
| Fetal complications‡ | 1 (4.0) | 10 (5.6) | 1.000 |
Values are presented as mean±standard deviation or number (%). Abbreviations: GBS, group B Streptococcus agalactiae; SPTL, spontaneous preterm labor; pPROM, preterm premature rupture of membrane; IIOC, incompetent internal os of cervix.
Table 3.
Neonatal Outcomes between GBS (+) and GBS (−) in Preterm Birth
| GBS (+) (n=25, 12.3%) | GBS (−) (n=178, 87.7%) | P-value | |
|---|---|---|---|
| Gestational age at delivery (weeks) | 32.7±3.3 | 32.3±3.3 | 0.154∗ |
| Birth weight (g) | 2,126±851 | 1,894±676 | 0.114∗ |
| Apgar score 1 minute | 7.6±1.7 | 7.6±1.9 | 0.295∗ |
| Apgar score 5 minutes | 9.0±1.1 | 9.0±1.4 | 0.273∗ |
| Hospitalization period (days) | 32.8±40.5 | 32.7±40.0 | 0.412∗ |
| Duration of mechanical ventilation (days) | 15.6±33.1 | 13.9±29.9 | 0.494∗ |
| Neonatal CRP within three days | 0.40±0.82 | 0.25±0.57 | 0.094∗ |
| RDS (%) | 7 (11.7) | 53 (88.3) | 1.000† |
| Neonatal deaths (%) | 1 (12.5) | 7 (87.5) | 1.000† |
Table 4.
Logistic Regression-Derived ORs and 95% CIs for the Association between GBS and pPROM
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