Objectives: Preterm delivery (PTD) contributes to 70% of all perinatal deaths and nearly 50% of permanent neurological damages in children. Treatment and follow-up to prevent recolonization in pregnant women with Group B Streptococcus (GBS) in the urine may reduce the frequency of PTD. In a Cochrane review, the incidence of low birth weight infants was reduced, however, not for PTD. The association between asymptomatic bacteriuria during pregnancy and PTD remains controversial. The objective of this study was to investigate whether there is an association between GBS bacteriuria (BU) in pregnancy and PTD. Method: A retrospective population-based cohort consisting of 36,097 pregnant women from Hospital Lillebaelt area, Denmark, during January 2002-December 2012, of whom 37.2% (equivalent to 13,417) have undergone culture of their urine at the Department of Clinical Microbiology. Information on gestational age at birth and testing for GBS and other significant variables were obtained from the National Birth Register. Pregnant women with positive BU and GBS and pregnant women with negative BU and GBS were primarily compared for the occurrence of PTD. For statistical analyzes, we mainly used bivariate tests including Chi-square, Student's t-test, stratified analyzes, and multivariate regression analyzes. Results: Out of 13,417 singleton deliveries, 6.9% (n 921) of women had asymptomatic GBS BU during their pregnancy, and 9.1% (n 1,218) delivered preterm. Among women with GBS BU 133 delivered preterm (10.9%), while among the GBS BU negative 1,085 (8.7%) delivered preterm; indicating an association between GBS BU and PTD in crude analyzes (Odds Ratio 1.8; 95% Confidence Interval 1.5-2.2; P30, and 19.0% were smokers in pregnancy. Conclusions: Group B Streptococcus bacteriuria might be a risk factor for preterm delivery.
International Journal of Gynecology and Obstetrics, 2015, Vol 131, Issue S5
*Streptococcus agalactiae *premature labor *cohort analysis *gynecology *obstetrics *bacteriuria human female pregnant woman pregnancy population urine follow up low birth weight smoking risk factor asymptomatic bacteriuria child Student t test perinatal death gestational age register microbiology Denmark hospital risk confidence interval uterine cervix biopsy