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The Histologic Fetoplacental Inflammatory Response in Fatal Perinatal Group B-Streptococcus Infection

Journal of Perinatology volume 24, pages 441–445 (2004)Cite this article

Abstract

OBJECTIVE: To determine the rate of histologic fetoplacental inflammation in fetuses and newborns with fatal perinatal Group B-Streptococcus (GBS) infection.

STUDY DESIGN: Autopsy files (1990 to 2002) were searched for fetuses and newborns with GBS-positive post-mortem blood and/or lung cultures. The rate of histological fetoplacental inflammation in preterm (<36 weeks gestational age) and term (≥36 weeks) fetuses/infants was compared using χ2 test.

RESULTS: GBS infection was diagnosed in 4.9% (61/1236) of perinatal autopsies and was considered the exclusive cause of death in 58 cases (16 to 41 weeks gestation, median: 26 weeks). A total of 43 fetuses/infants (74%) were preterm, 24 (41%) were male and 33 (57%) stillborn. The histologic fetoplacental inflammatory response was age-dependent for the following variables: acute chorioamnionitis (seen in 67% of preterm vs 33% of term fetuses/infants, p < 0.05), multiple-vessel umbilical vasculitis (37 vs 7%, p < 0.05), funisitis (37 vs 13%, p < 0.05), and the presence of neutrophils in the gastrointestinal tract (35% vs none, p < 0.05). Neutrophils in the pulmonary airspaces (47 vs 33%) and pneumonia (16 vs 27%) were found with similar frequency in both groups.

CONCLUSION: Histologic fetoplacental inflammation is a poor indicator of perinatal GBS infection; the sensitivity is 67% in preterm and 33% in term fetuses/newborns (overall sensitivity 59%). The higher rate of histologic inflammation in preterm fetuses/newborns suggests age-specific interactions between microorganism, host and placenta.

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Acknowledgements

We thank Ms. Valerie Luks for helpful discussions and assistance in data collection.

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Authors and Affiliations

  1. Department of Pathology, Women and Infants Hospital and Brown Medical School, Providence, RI, USA

    Monique E De Paepe MD, Rebecca M Friedman BA, Fusun Gundogan MD, Halit Pinar MD & Calvin E Oyer MD

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  1. Monique E De Paepe MD
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  2. Rebecca M Friedman BA
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De Paepe, M., Friedman, R., Gundogan, F. et al. The Histologic Fetoplacental Inflammatory Response in Fatal Perinatal Group B-Streptococcus Infection. J Perinatol 24, 441–445 (2004). https://doi.org/10.1038/sj.jp.7211129

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