Risk Factors for Group B Streptococcal Disease in Neonates of Mothers with Negative Antenatal Testing

Overview

Journal J Perinatol

Specialty Gynecology & Obstetrics

Date 2016 Nov 18

PMID 27853322

Citations 9

Authors

V Parente

R H Clark

L Ku

C Fennell

M Johnson

E Morris

A Romaine

U Utin

D K Benjamin

J A Messina

P B Smith

R G Greenberg

Affiliations

Soon will be listed here.

Abstract

Objective: The aim of this study was to identify risk factors for early-onset group B Streptococcus (EOGBS) disease in neonates of mothers with negative antenatal screening.

Study Design: We performed a retrospective cohort study of neonates born to mothers with negative antenatal GBS screening between 2002 and 2012. Our primary outcome was EOGBS infection. We used multivariable logistic regression to assess factors associated with EOGBS.

Results: EOGBS was confirmed in 492 of the 179 818 neonates that met the study inclusion criteria. Risk factors for EOGBS included black race (reference: white, odds ratio (OR) =1.81 (95% confidence interval: 1.43, 2.31)), maternal age <18 years (reference: >35 years, OR=2.63 (1.54, 4.51)) and maternal age 18 to 35 years (reference: >35 years, OR=1.94 (1.30, 2.88)).

Conclusion: Maternal age <18 years and black race were the strongest predictors of EOGBS. Further research investigating contributors to the discordance between screening results and neonatal outcomes in these populations is needed.

Citing Articles

Incidence and outcomes of neonatal group B streptococcal sepsis in Qatar-a multicentre study.

Thyvilayil S, Vellamgot A, Salameh K, Kurunthattilthazhe S, Elikkottil A, Dominguez L BMC Pediatr. 2025; 25(1):41.

PMID: 39825283 PMC: 11740512. DOI: 10.1186/s12887-025-05398-x.

Prospective study of peripartum group B streptococcus colonization in Japanese mothers and neonates.

Yoshida E, Takeda J, Maruyama Y, Suga N, Takeda S, Arai H Epidemiol Infect. 2025; 153():e1.

PMID: 39757949 PMC: 11704933. DOI: 10.1017/S0950268824001560.

Vaginal and Rectal microbiome changes following administration of a multi-species antenatal probiotic: A randomized control trial.

Malloy E, Kates A, Dixon J, Riley C, Safdar N, Hanson L Gut Microbes Rep. 2024; 1(1):1-10.

PMID: 38708373 PMC: 11065196. DOI: 10.1080/29933935.2024.2334311.

Neonatal Group B infection at a single center in Al-Madinah Al-Munawarah, Saudi Arabia.

Surrati A, Alharbi K, Mohammedsaeed W, Almohammadi H Saudi Med J. 2024; 45(2):163-170.

PMID: 38309734 PMC: 11115410. DOI: 10.15537/smj.2024.45.2.20230533.

Vaginal Carriage of Group B (GBS) in Pregnant Women, Antibiotic Sensitivity and Associated Risk Factors in Dakar, Senegal.

Ngom N, Gassama O, Dieng A, Diakhaby E, Ndiaye S, Tine A Microbiol Insights. 2023; 16:11786361231174419.

PMID: 37275206 PMC: 10233617. DOI: 10.1177/11786361231174419.

References

Hoogkamp-Korstanje J, Gerards L, Cats B . Maternal carriage and neonatal acquisition of group B streptococci. J Infect Dis. 1982; 145(6):800-3. DOI: 10.1093/infdis/145.6.800. View

Edwards R, Novak-Weekley S, Koty P, Davis T, Leeds L, Jordan J . Rapid group B streptococci screening using a real-time polymerase chain reaction assay. Obstet Gynecol. 2008; 111(6):1335-41. DOI: 10.1097/AOG.0b013e31817710ee. View

Vogel L, Boyer K, Gadzala C, GOTOFF S . Prevalence of type-specific group B streptococcal antibody in pregnant women. J Pediatr. 1980; 96(6):1047-51. DOI: 10.1016/s0022-3476(80)80639-1. View

Verani J, Schrag S . Group B streptococcal disease in infants: progress in prevention and continued challenges. Clin Perinatol. 2010; 37(2):375-92. PMC: 11848810. DOI: 10.1016/j.clp.2010.02.002. View

Koenig J, Keenan W . Group B streptococcus and early-onset sepsis in the era of maternal prophylaxis. Pediatr Clin North Am. 2009; 56(3):689-708, Table of Contents. PMC: 2702484. DOI: 10.1016/j.pcl.2009.04.003. View

Zaleznik D, Rench M, Hillier S, Krohn M, Platt R, Lee M . Invasive disease due to group B Streptococcus in pregnant women and neonates from diverse population groups. Clin Infect Dis. 2000; 30(2):276-81. DOI: 10.1086/313665. View

Lewin E, Amstey M . Natural history of group B streptococcus colonization and its therapy during pregnancy. Am J Obstet Gynecol. 1981; 139(5):512-5. DOI: 10.1016/0002-9378(81)90509-3. View

Stoll B, Hansen N, Sanchez P, Faix R, Poindexter B, Van Meurs K . Early onset neonatal sepsis: the burden of group B Streptococcal and E. coli disease continues. Pediatrics. 2011; 127(5):817-26. PMC: 3081183. DOI: 10.1542/peds.2010-2217. View

Schrag S, Zell E, Lynfield R, Roome A, Arnold K, Craig A . A population-based comparison of strategies to prevent early-onset group B streptococcal disease in neonates. N Engl J Med. 2002; 347(4):233-9. DOI: 10.1056/NEJMoa020205. View

10.

Van Dyke M, Phares C, Lynfield R, Thomas A, Arnold K, Craig A . Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009; 360(25):2626-36. DOI: 10.1056/NEJMoa0806820. View

11.

Benitz W, Gould J, Druzin M . Risk factors for early-onset group B streptococcal sepsis: estimation of odds ratios by critical literature review. Pediatrics. 1999; 103(6):e77. DOI: 10.1542/peds.103.6.e77. View

12.

Puopolo K, Madoff L, Eichenwald E . Early-onset group B streptococcal disease in the era of maternal screening. Pediatrics. 2005; 115(5):1240-6. DOI: 10.1542/peds.2004-2275. View

13.

Kwatra G, Adrian P, Shiri T, Buchmann E, Cutland C, Madhi S . Serotype-specific acquisition and loss of group B streptococcus recto-vaginal colonization in late pregnancy. PLoS One. 2014; 9(6):e98778. PMC: 4076185. DOI: 10.1371/journal.pone.0098778. View

14.

Schuchat A, Oxtoby M, Cochi S, SIKES R, Hightower A, Plikaytis B . Population-based risk factors for neonatal group B streptococcal disease: results of a cohort study in metropolitan Atlanta. J Infect Dis. 1990; 162(3):672-7. DOI: 10.1093/infdis/162.3.672. View

15.

Heath P, Balfour G, Weisner A, Efstratiou A, Lamagni T, Tighe H . Group B streptococcal disease in UK and Irish infants younger than 90 days. Lancet. 2004; 363(9405):292-4. DOI: 10.1016/S0140-6736(03)15389-5. View

16.

Meyn L, Moore D, Hillier S, Krohn M . Association of sexual activity with colonization and vaginal acquisition of group B Streptococcus in nonpregnant women. Am J Epidemiol. 2002; 155(10):949-57. DOI: 10.1093/aje/155.10.949. View

17.

Madzivhandila M, Adrian P, Cutland C, Kuwanda L, Schrag S, Madhi S . Serotype distribution and invasive potential of group B streptococcus isolates causing disease in infants and colonizing maternal-newborn dyads. PLoS One. 2011; 6(3):e17861. PMC: 3061872. DOI: 10.1371/journal.pone.0017861. View

18.

Lin F, Philips 3rd J, Azimi P, Weisman L, Clark P, Rhoads G . Level of maternal antibody required to protect neonates against early-onset disease caused by group B Streptococcus type Ia: a multicenter, seroepidemiology study. J Infect Dis. 2001; 184(8):1022-8. DOI: 10.1086/323350. View

19.

Baker C, Edwards M, Kasper D . Role of antibody to native type III polysaccharide of group B Streptococcus in infant infection. Pediatrics. 1981; 68(4):544-9. View

20.

Goodman J, Berg R, Gribble R, Meier P, Fee S, MITCHELL P . Longitudinal study of group B streptococcus carriage in pregnancy. Infect Dis Obstet Gynecol. 1997; 5(3):237-43. PMC: 2364546. DOI: 10.1155/S1064744997000409. View