L C Colicchia1, D S Lauderdale2, H Du3, M Adams3, E Hirsch4. 1. 1] Department of Obstetrics and Gynecology, NorthShore University Health System, Evanston, IL, USA [2] Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA [3] Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA. 2. Department of Health Studies, University of Chicago, Chicago, IL, USA. 3. NorthShore University Health System Research Institute, Evanston, IL, USA. 4. 1] Department of Obstetrics and Gynecology, NorthShore University Health System, Evanston, IL, USA [2] Department of Obstetrics and Gynecology, University of Chicago, Chicago, IL, USA.
Abstract
OBJECTIVE: To identify risk factors for group B streptococcus (GBS) colonization in a subsequent pregnancy using microbiological and clinical data from a prior pregnancy. STUDY DESIGN: A retrospective cohort study of women over a 10-year period, using laboratory records to identify women with GBS culture results available in two successive pregnancies. RESULT: One thousand eight hundred and ninety-four women met eligibility criteria. Of these, 1293 were not GBS-colonized in either pregnancy, 198 were colonized in both pregnancies and 403 had discordant colonization status. GBS colonization in the index pregnancy was positively associated with multiparity, premature delivery and lower maternal age and negatively associated with chorioamnionitis. The strongest predictor of colonization in a subsequent pregnancy was colonization in the index pregnancy (50% likelihood if colonized compared with 14% if not in the index pregnancy, relative risk 3.6, confidence interval (CI)=3.1 to 4.3). GBS colonization in the subsequent pregnancy was independently associated with: GBS colonization in the index pregnancy (odds ratio (OR)=6.28; CI=4.91 to 8.05), preterm delivery in the index pregnancy (OR=1.80; CI=1.05 to 3.09) and prior early pregnancy loss (OR=1.15; CI=1.04 to 1.27). CONCLUSION: GBS colonization in a prior pregnancy is informative of colonization in a subsequent pregnancy. These data support providing antimicrobial prophylaxis in unscreened parous women with known prior GBS colonization.
OBJECTIVE: To identify risk factors for group B streptococcus (GBS) colonization in a subsequent pregnancy using microbiological and clinical data from a prior pregnancy. STUDY DESIGN: A retrospective cohort study of women over a 10-year period, using laboratory records to identify women with GBS culture results available in two successive pregnancies. RESULT: One thousand eight hundred and ninety-four women met eligibility criteria. Of these, 1293 were not GBS-colonized in either pregnancy, 198 were colonized in both pregnancies and 403 had discordant colonization status. GBS colonization in the index pregnancy was positively associated with multiparity, premature delivery and lower maternal age and negatively associated with chorioamnionitis. The strongest predictor of colonization in a subsequent pregnancy was colonization in the index pregnancy (50% likelihood if colonized compared with 14% if not in the index pregnancy, relative risk 3.6, confidence interval (CI)=3.1 to 4.3). GBS colonization in the subsequent pregnancy was independently associated with: GBS colonization in the index pregnancy (odds ratio (OR)=6.28; CI=4.91 to 8.05), preterm delivery in the index pregnancy (OR=1.80; CI=1.05 to 3.09) and prior early pregnancy loss (OR=1.15; CI=1.04 to 1.27). CONCLUSION:GBS colonization in a prior pregnancy is informative of colonization in a subsequent pregnancy. These data support providing antimicrobial prophylaxis in unscreened parous women with known prior GBS colonization.
Authors: Barbara J Stoll; Nellie I Hansen; Pablo J Sánchez; Roger G Faix; Brenda B Poindexter; Krisa P Van Meurs; Matthew J Bizzarro; Ronald N Goldberg; Ivan D Frantz; Ellen C Hale; Seetha Shankaran; Kathleen Kennedy; Waldemar A Carlo; Kristi L Watterberg; Edward F Bell; Michele C Walsh; Kurt Schibler; Abbot R Laptook; Andi L Shane; Stephanie J Schrag; Abhik Das; Rosemary D Higgins Journal: Pediatrics Date: 2011-04-25 Impact factor: 7.124
Authors: Stephanie J Schrag; Elizabeth R Zell; Ruth Lynfield; Aaron Roome; Kathryn E Arnold; Allen S Craig; Lee H Harrison; Arthur Reingold; Karen Stefonek; Glenda Smith; Melanie Gamble; Anne Schuchat Journal: N Engl J Med Date: 2002-07-25 Impact factor: 91.245
Authors: Gerald A Capraro; Sajel Lala; Khaldia Khaled; Elizabeth Gosciniak; Brianna Saadat; Sarah M Alvarez; Seema Kumar; Tara Calhoun; Edward Landry; Gloria Caldito; Joseph A Bocchini; John A Vanchiere Journal: Antimicrob Resist Infect Control Date: 2020-11-04 Impact factor: 4.887