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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (5): 669-674    DOI: 10.31083/j.ceog.2020.05.5411
Original Research Previous articles | Next articles
Detection of group B streptococcus colonization in cervical and lower vaginal secretions of pregnant women
Y.X. Wang1, 2, M. Zhong1, *(), H. Yi2, H.F. He2
1Nanfang Hospital of Southern Medical University, Guangzhou, 510515, P.R. China
2Shenzhen Futian Maternal and Child Health Hospital, Shenzhen, 518045, P.R. China
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Abstract  

Objective: To examine the efficacy of cervical and lower vaginal secretions in the detection of group B streptococcus (GBS) colonization in women in early and late pregnancy. Materials and Methods: Two-thousand women in early pregnancy (8-12 weeks of gestation) aged approximately 27 years who visited our outpatient clinic from December 2016 to December 2018 were enrolled. Cervical and lower vaginal secretions were obtained at 8-12 weeks (early pregnancy) and then at 37 weeks (late pregnancy) of gestation and screened for GBS infection. Patients were classified as follows: (i) cervical and lower vaginal secretions were GBS-positive (group A), (ii) only cervical secretions were GBS-positive (group B), (iii) only lower vaginal secretions were GBS-positive (group C), and (iv) both cervical and lower vaginal secretions were GBS-negative (group D). Results: No difference in the GBS-positive rate was observed between women in early and late pregnancy. The GBS-positive detection rate was lower in women from which cervical secretions were screened than that in women from which lower vaginal secretions were assayed; however, the incidence rates of adverse pregnancy events, such as abortion, preterm delivery, premature rupture of membranes and neonatal infection, were higher in women in which cervical secretions were assayed. Conclusion: Women in early pregnancy should be screened for GBS infection using cervical secretions.

Key words:  Pregnancy      Group B streptococcus      Cervical secretions      Vaginal secretions      Neonate     
Submitted:  16 October 2019      Accepted:  09 June 2020      Published:  15 October 2020     
Fund: 
FTWS2018034/Public welfare fund project in Shenzhen, Futian District
*Corresponding Author(s):  M. Zhong     E-mail:  zhongmei20189@163.com

Cite this article: 

Y.X. Wang, M. Zhong, H. Yi, H.F. He. Detection of group B streptococcus colonization in cervical and lower vaginal secretions of pregnant women. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(5): 669-674.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.05.5411     OR     https://ceog.imrpress.com/EN/Y2020/V47/I5/669

Figure 1.  — The flow chart of this study.

Table 1  — General information of pregnant women.
Group Cases (n) Age (years) BMI (Kg/m2) Gestational Weeks (w) Medical Illness (n) Parity (n)
A 62 29.58 ± 5.79 22.75 ± 2.71 10.0 ± 1.5 3.72 ± 2.01 1.83 ± 0.93
B 69 28.98 ± 4.92 22.82 ± 2.83 9.8 ± 1.3 4.83 ± 2.34 2.03 ± 1.02
C 123 29.50 ± 5.77 22.28 ± 3.11 9.6 ± 1.1 6.77 ± 3.12 1.95 ± 0.85
D 1746 28.95 ± 5.12 23.01 ± 3.01 9.7 ± 1.2 69.84 ± 11.45 2.01 ± 1.05
F --- 0.696 2.41 1.693 2650 0.727
p --- 0.5545 0.0652 0.1664 0.9958 0.5361
Table 2  — Comparison of the rate of pregnant women, abortion and premature delivery among the four groups women in early pregnancy.
Group Pregnant women
n (%) (n = 2000)
Abortion n (%)
(n = 33)
Premature delivery n (%)
(n = 115)
A 62 (3.1)
69 (3.45)
123 6.15)
1746(87.3)
3 (4.48)
4 (5.80)
3 (2.44)
23 (1.32)
9(14.52)
9 (13.04)
8 (6.50)
89 (5.10)
B
C
D
χ2 --- 12.0514 14.2272
p --- 0.0072 0.0026
Table 4  — Comparison of GBS positive rate of pregnant women in early and late pregnancy.
Gestational Weeks
(w)
Cases
(n)
GBS Positive Cases GBS Negative Cases χ2 p
n (%) n (%)
8-12 2000 254 (12.70) 1746 (87.30) 0.0016 0.9681
37 1852 236 (12.74) 1616 (87.26)
Table 3  — Cases of four groups women at the 37th gestation week and consequent PROM and neonatal infection events.
Group Pregnant Women
n (%) (n = 1852)
PROM Events
n (%) (n = 187)
Neonatal Infection Events
(GBS infection) n (%) (n = 4)
A 56 (3.02) 13 (23.21) 1 (1.79)
B 57 (3.08) 14 (24.56) 1 (1.75)
C 123 (6.64) 20 (16.26) 2 (1.63)
D 1616 (87.26) 140 (8.63) 0 (0.00)
χ2 --- 24.2339 27.0466
p --- 0.0000 0.0000
Table 5  — The final outcome of four groups women.
Group Cases (n) Termination of Gestational Weeks (w) Neonatal Weight
(Kg)
Neonatal GBS Carriers n (%) Neonatal GBS Infectors n (%) Neonatal Intensive Care Cases n (%)
A 62 38.4 ± 0.65 3.296 ± 0.4268 6 ( 9.68) 2 (3.23) 2 (3.23)
B 69 38.3 ± 0.47 3.312 ± 0.5716 6 (8.70) 2 (2.90) 1 (1.45)
C 123 38.5 ± 0.39 3.2302 ± 0.5605 10 (8.13) 6 (4.88) 2 (1.63)
D 1746 38.6 ± 0.55 3.310 ± 0.4989 0 (0) 7 (4.01) 5 (2.86)
F2 --- 18.23 0.025 --- 33.8120 14.8094
p --- 0.9205 0.9947 < 0.01 < 0.01 0.0020
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