Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Racial disparities in intrapartum group B Streptococcus colonization: a higher incidence of conversion in African American women

Journal of Perinatology volume 39, pages 433–438 (2019)Cite this article

Subjects

Abstract

Objective

To compare the incidence of group B Streptococcus (GBS) conversion from a negative antepartum to a positive intrapartum culture among women who self-identify as non-Hispanic black, Hispanic, or non-Hispanic white.

Study design

This was a prospective cohort study of women with a negative rectovaginal GBS culture obtained within 35 days of enrollment. An intrapartum rectovaginal swab was collected and cultured for GBS. Data were compared with chi-square, Fisher’s exact, or Wilcoxon rank-sum test. Modified Poisson regression was used.

Results

We enrolled 737 women; 75.4% were non-Hispanic white, 17.6% were non-Hispanic black, and 6.9% were Hispanic. Non-Hispanic black women were more likely to convert to GBS positive than non-Hispanic white women, 9.2% as compared to 5.3% (RR: 2.0; 95% CI: 1.02–3.8).

Conclusion

The increased incidence of positive intrapartum GBS cultures among non-Hispanic black women suggests that non-Hispanic black race is a risk factor for GBS conversion in the late third trimester.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Active Bacterial Core Surveillance (ABCs) Report, Emerging Infections Program Network, Group B Streptococcus, 2015. https://www.cdc.gov/abcs/reports-findings/survreports/gbs15.xpdf.

  2. Phares CR, Lynfield R, Farley MM, Mohle-Boetani J, Harrison LH, Petit S, et al. Active Bacterial Core surveillance/Emerging Infections Program Network. JAMA. 2008;299:2056.

    Article  CAS  Google Scholar 

  3. Trends in perinatal group B streptococcal disease–United States, 2000–2006. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5805a2.htm.

  4. Goins WP, Talbot TR, Schaffner W, Edwards KM, Craig AS, Schrag SJ, et al. Adherence to perinatal group B streptococcal prevention guidelines. Obstet Gynecol. 2010;115:1217–24.

    Article  Google Scholar 

  5. Puopolo KM, Madoff LC, Eichenwald EC. Early-onset group B streptococcal disease in the era of maternal screening. Pediatrics. 2005;115:1240–6.

    Article  Google Scholar 

  6. Van Dyke MK, Phares CR, Lynfield R, Thomas AR, Arnold KE, Craig AS, et al. Evaluation of universal antenatal screening for group B streptococcus. N Engl J Med. 2009;360:2626–36.

    Article  Google Scholar 

  7. Verani JR, Spina NL, Lynfield RR, Schaffner W, Harrison LH, Hoist A, et al. Early-onset group B streptococcal disease in the United States: potential for further reduction. Obstet Gynecol. 2014;123:828–37.

    Article  Google Scholar 

  8. ACOG Committee Opinion No. 485: Prevention of early-onset group B streptococcal disease in newborns. Obstet Gynecol. 2011;117:1019–27.

  9. Prevention of Perinatal Group B Streptococcal Disease: Revised Guidelines from CDC, 2010. https://www.cdc.gov/mmwr/pdf/rr/rr5910.pdf.

  10. Young BC, Dodge LE, Gupta M, Rhee JS, Hacker MR. Evaluation of a rapid, real-time intrapartum group B streptococcus assay. Am J Obstet Gynecol. 2011;205:372–6.

    Article  Google Scholar 

  11. Valkenburg-van den Berg AW, Sprij AJ, Oostvogel PM, Mutsaers JAEM, Rosendaal FR, Dorr PJ. Prevalence of colonization with group B Streptococci in pregnant women of a multi-ethnic population in The Netherlands. Eur J Obstet Gynecol Reprod Biol. 2006;124:178–83.

    Article  Google Scholar 

  12. Abdelazim IA. Intrapartum polymerase chain reaction for detection of group B Streptococcus colonisation. Aust N Z J Obstet Gynaecol. 2013;53:236–42.

    Article  Google Scholar 

  13. Towers CV, Rumney PJ, Asrat T, Preslicka C, Ghamsary MG, Nageotte MP. The accuracy of late third-trimester antenatal screening for group B streptococcus in predicting colonization at delivery. Am J Perinatol. 2010;27:785–90.

    Article  Google Scholar 

  14. Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) - A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf. 2009;42:377–81.

    Article  Google Scholar 

  15. Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159:702–6.

    Article  Google Scholar 

  16. El Helali N, Nguyen JC, Ly A, Giovangrandi Y, Trinquart L. Diagnostic accuracy of a rapid real-time polymerase chain reaction assay for universal intrapartum group B S treptococcus screening. Clin Infect Dis. 2009;49:417–23.

    Article  CAS  Google Scholar 

  17. Alfa MJ, Sepehri S, De GP, Helawa M, Sandhu G, Harding GK, et al. assay provides reliable assessment of intrapartum carriage of group B Streptococcus. J Clin Microbiol. 2010;48:3095–9.

    Article  Google Scholar 

  18. Davies HD, Miller MA, Faro S, Gregson D, Kehl SC, Jordan JA. Multicenter study of a rapid molecular-based assay for the diagnosis of group B streptococcus colonization in pregnant women. Clin Infect Dis. 2004;39:1129–35.

    Article  Google Scholar 

  19. De Tejada BM, Pfister RE, Renzi G, François P, Irion O, Boulvain M, et al. Intrapartum group B streptococcus detection by rapid polymerase chain reaction assay for the prevention of neonatal sepsis. Clin Microbiol Infect. 2011;17:1786–91.

    Article  Google Scholar 

  20. Gavino M, Wang E. A comparison of a new rapid real-time polymerase chain reaction system to traditional culture in determining group B Streptococcus colonization. Am J Obstet Gynecol. 2007;197:388–4.

    Article  Google Scholar 

  21. Edwards RK, Novak-Weekley SM, Koty PP, Davis T, Leeds LJ, Jordan JA. Rapid group B streptococci screening using a real-time polymerase chain reaction assay. Obstet Gynecol. 2008;111:1335–41.

    Article  Google Scholar 

  22. Boyer KM, Gadzala CA, Kelly PD, Burd LI, Gotoff SP.Selective intrapartum chemoprophylaxis of neonatal group B streptococcal early-onset disease. II. Predictive value of prenatal cultures. J Infect Dis. 1983;148:802

    Article  CAS  Google Scholar 

  23. Regan JA, Klebanoff MA, Nugent RP, Eschenbach DA, Blackwelder WC, Lou Y, et al. Colonization with group B streptococci in pregnancy and adverse outcome. Am J Obset Gynecol. 1996;17:1354.

    Article  Google Scholar 

  24. Yancey MK, Schuchat A, Brown LK, Ventura VL, Markenson GR. The accuracy of late antenatal screening cultures in predicting genital group B streptococcal colonization at delivery. Obstet Gynecol. 1996;88:811–5.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA

    Melissa H. Spiel, Michele R. Hacker, Miriam J. Haviland, Bethany Mulla, Elizabeth Roberts, Laura E. Dodge & Brett C. Young

  2. Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA, USA

    Melissa H. Spiel, Michele R. Hacker, Miriam J. Haviland, Bethany Mulla, Elizabeth Roberts, Laura E. Dodge & Brett C. Young

Authors
  1. Melissa H. Spiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michele R. Hacker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Miriam J. Haviland
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bethany Mulla
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elizabeth Roberts
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Laura E. Dodge
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Brett C. Young
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brett C. Young.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Spiel, M.H., Hacker, M.R., Haviland, M.J. et al. Racial disparities in intrapartum group B Streptococcus colonization: a higher incidence of conversion in African American women. J Perinatol 39, 433–438 (2019). https://doi.org/10.1038/s41372-018-0308-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-018-0308-3

Search

Advanced search

Quick links