A Meta-Analysis for Association of Maternal Group B Streptococcus Colonization and Preterm Birth in Indian Population
20 Pages Posted: 25 Oct 2018More...
Vaginal colonization of Group B streptococci (GBS) is known to be associated with increased risk of preterm birth. However, the prevalence of maternal colonization with GBS and its association with preterm births in the Indian context is an unrecognised and neglected problem.
Method: To determine the prevalence of Group B streptococci infection and the associated risk factors in pregnant Indian women, we did a meta-analysis by collecting data from 34 (1981-2017) studies comprising 9552 cases. The main outcome measures were prevalence of GBS colonization, factors that could influence the prevalence of GBS infection and the incidence of preterm birth and Premature Rupture Of Membrane (PROM) amongst GBS infected women.
Result: The prevalence of GBS infection in pregnant Indian women (35-37 weeks of gestation) is 7·7 % (744/9552) with a wide heterogeneity (CI 7·2-8·3%). The prevalence of GBS was 7·4% when culture method was used, 11·6% with the use of immunological method and 62% with use of molecular method. Detection rate for GBS almost doubled when enrichment was used in the culture method (8·1 vs. 4·4%). While most GBS infected women were asymptomatic. The prevalence of GBS colonization was higher in younger women (18-25 years) as compared to older (30-35 years) women (6·7% vs 3·6%), The risk of preterm delivery and PROM was higher amongst GBS infected women as compared to uninfected women (OR 7·9 and 5·5 respectively).
Interpretation: The prevalence of GBS is lower in in pregnant Indian women, however the risk of PROM and preterm births is relatively high.
Registration of Manuscript: The present manuscript bears the NIRRH ID: RA/689/10-18.
Funding Statement: Indian Council of Medical Research (ICMR)
Declaration of Interests: The authors declare no Conflict of Interest. DM lab at NIRRH is funded by ICMR, Department of Biotechnology (DBT) and Department of Science and Technology (DST) Govt of India.
Ethics Approval Statement: Not Applicable
Keywords: Preterm Birth, Group B Streptococci, GBS, Infection, PROM, India, Pregnancy, Women, Vaginal Colonization
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