Group B streptococcal prevalence in internal organs and placentas of deceased neonates and stillbirths in South Asia

Abstract

AbstractObjectiveGroup B streptococcus (GBS) has been associated with adverse pregnancy outcomes, but few prospective studies have assessed its prevalence in low‐ and middle‐income country settings. We sought to evaluate the prevalence of GBS by polymerase chain reaction (PCR) in internal organ tissues and placentas of deceased neonates and stillbirths.DesignThis was a prospective, observational study.SettingThe study was conducted in hospitals in India and Pakistan.PopulationPregnant women with stillbirths or preterm births were recruited at delivery, as was a group of women with term, live births, to serve as a control group.MethodsA rectovaginal culture was collected from the women in Pakistan to assess GBS carriage. Using PCR, we evaluated GBS in various tissues of stillbirths and deceased neonates and their placentas, as well as the placentas of live‐born preterm and term control infants.Main outcome measuresGBS identified by PCR in various tissues and the placentas; rate of stillbirths and 28‐day neonatal deaths.ResultsThe most obvious finding from this series of analyses from India and Pakistan was that no matter the country, the condition of the subject, the tissue studied or the methodology used, the prevalence of GBS was low, generally ranging between 3% and 6%. Among the risk factors evaluated, only GBS positivity in primigravidae was increased.ConclusionsGBS diagnosed by PCR was identified in <6% of internal organs of stillbirths and neonatal deaths, and their placentas, and control groups in South Asian sites. This is consistent with other reports from South Asia and is lower than the reported GBS rates from the USA, Europe and Africa.