Correlation between Group B Streptococcus Infection in The Vagina with Maternal Serum C-Reactive Protein Levels in Preterm Labor

Abstract

For decades GBS has been the most common cause of early-onset of neonatal infection. Ascending route infection with Group B Streptococcus bacteria increases the risk of preterm premature rupture of membranes, fetus infection, sepsis, preterm birth, and meningitis in infants. C-Reactive Protein is a sensitive marker of systemic inflammation where an increase in CRP can also be triggered by GBS infection. Objective of this study is to determine the relationship between Group B Streptococcus infection in the vagina of pregnant women and maternal serum C-Reactive Protein levels in preterm labor. The design of this study was cross-sectional in the preterm delivery population. This study was conducted in the obstetrics delivery room at Sanglah Hospital from January 2021 to January 2022. A total of 31 samples met the inclusion criteria, each of which was examined for vaginal swab culture and maternal serum CRP levels. Vaginal swab samples were processed at the Microbiology Laboratory of Sanglah Hospital, Denpasar. Maternal serum CRP samples were processed at the Clinical Pathology Laboratory of Sanglah Hospital, Denpasar. Bivariate analysis using Chi-square test. The relationship between GBS infection and maternal serum CRP levels using the Prevalence Ratio. The growth of Streptococcus agalactiae from vaginal swab culture was 7 samples (22.58%). Positive GBS in the group of high maternal serum CRP levels were found in 6 patients (19.4%) and the group of low maternal serum CRP levels as many as 1 patient (3.2%) while negative GBS in the group of high maternal serum CRP levels were found in 5 patients (16.1%) and 19 patients (61.3%) in the group of low maternal serum CRP levels. The Prevalence Ratio value obtained was 4.1 (1.78-9.49, 95% CI; p = 0.002). There is a positive relationship between GBS infection and maternal CRP serum levels in preterm labor where positive GBS is a risk factor that increases maternal CRP serum levels in preterm labor.