Abstract
In a prospective study of 1684 women admitted with ruptured membranes, in labor or for induction, 231 were found to have cervical cultures positive for GBS. In 16% of the colonized population membrane rupture occurred a minimum of one hour prior to onset of regular contractions (PROM) vs. 8% of the total population studied (p<.005 ×2 = 15.1, 1 df). Conversely, of the 136 women with PROM, 37 (26%) were colonized with GBS compared to the overall colonization rate of 14% in the total population studied (p≪.005, ×2 = 18.6, 1 df). Thus a significant association was found between maternal GBS colonization and PROM. Furthermore, there were 16 (7%) pre-term deliveries at or prior to 32 weeks among 231 colonized women vs. 30 (1.8%) among the 1684 women studied. (p≪.005,×2=29.2, 1 df) 8 of the 16 pre-term births in the colonized population followed PROM. Antenatal screening at 32 weeks gestation has become an established approach to the detection of maternal GBS colonization. The rationale for this schedule is that screening at 32 weeks allows time for therapeutic attempts to eradicate colonization prior to delivery at or near term. Our findings suggest that screening and treatment prior to 28 weeks might reduce the risk of preterm delivery since it appears that the presence of the pathogen in the mother may predispose to PROM and premature delivery prior to the 32nd week of gestation.
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