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Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses.

Bianchi-Jassir, F; Seale, AC; Kohli-Lynch, M; Lawn, JE; Baker, CJ; Bartlett, L; Cutland, C; Gravett, MG; Heath, PT; Ip, M; et al. Bianchi-Jassir, F; Seale, AC; Kohli-Lynch, M; Lawn, JE; Baker, CJ; Bartlett, L; Cutland, C; Gravett, MG; Heath, PT; Ip, M; Le Doare, K; Madhi, SA; Saha, SK; Schrag, S; Sobanjo-Ter Meulen, A; Vekemans, J; Rubens, CE (2017) Preterm Birth Associated With Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses. Clin Infect Dis, 65 (suppl_2). S133-S142. ISSN 1537-6591 https://doi.org/10.1093/cid/cix661
SGUL Authors: Heath, Paul Trafford

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Abstract

Background: Preterm birth complications are the leading cause of deaths among children <5 years of age. Studies have suggested that group B Streptococcus (GBS) maternal rectovaginal colonization during pregnancy may be a risk factor for preterm delivery. This article is the fifth of 11 in a series. We aimed to assess the association between GBS maternal colonization and preterm birth in order to inform estimates of the burden of GBS. Methods: We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data from investigator groups on the association of preterm birth (<37 weeks' gestation) and maternal GBS colonization (GBS isolation from vaginal, cervical, and/or rectal swabs; with separate subanalysis on GBS bacteriuria). We did meta-analyses to derive pooled estimates of the risk and odds ratios (according to study design), with sensitivity analyses to investigate potential biases. Results: We identified 45 studies for inclusion. We estimated the risk ratio (RR) for preterm birth with maternal GBS colonization to be 1.21 (95% confidence interval [CI], .99-1.48; P = .061) in cohort and cross-sectional studies, and the odds ratio to be 1.85 (95% CI, 1.24-2.77; P = .003) in case-control studies. Preterm birth was associated with GBS bacteriuria in cohort studies (RR, 1.98 [95% CI, 1.45-2.69]; P < .001). Conclusions: From this review, there is evidence to suggest that preterm birth is associated with maternal GBS colonization, especially where there is evidence of ascending infection (bacteriuria). Several biases reduce the chance of detecting an effect. Equally, however, results, including evidence for the association, may be due to confounding, which is rarely addressed in studies. Assessment of any effect on preterm delivery should be included in future maternal GBS vaccine trials.

Item Type: Article
Additional Information: © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: bacteriuria, colonization, group B Streptococcus, preterm delivery, preterm labor, group B Streptococcus, preterm delivery, preterm labor, colonization, bacteriuria, Microbiology, 06 Biological Sciences, 11 Medical And Health Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: Clin Infect Dis
ISSN: 1537-6591
Language: eng
Dates:
DateEvent
15 November 2017Published
6 November 2017Published Online
25 July 2017Accepted
Publisher License: Creative Commons: Attribution 4.0
Projects:
Project IDFunderFunder ID
OPP1131158Bill and Melinda Gates Foundationhttp://dx.doi.org/10.13039/100000865
UNSPECIFIEDWellcome Trusthttp://dx.doi.org/10.13039/100004440
UNSPECIFIEDMedical Research Councilhttp://dx.doi.org/10.13039/501100000265
PubMed ID: 29117329
Web of Science ID: WOS:000414511400005
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/109321
Publisher's version: https://doi.org/10.1093/cid/cix661

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