Prenatal-onset Group B Strep (POGBS) disease as a cause of perinatal morbidity and mortality

Prenatal-onset Group B Strep (POGBS) disease as a cause of perinatal morbidity and mortality

James A. McGregor, Marti Perhach

Group B Strep International

Background:
Intrauterine infection is increasingly recognized as a possibly preventable cause of stillbirth (SB). The objective of this review/analysis is to justify recognition of prenatal-onset group B strep (POGBS) sepsis, distinct from early-onset (EO) and late-onset (LO) infections from group B strep (GBS) and other microorganisms.

Methods:
Logic model analysis:
1) Conduct an expert systematic review and analysis of group B strep disease knowledge in order to justify recognition of POGBS sepsis, distinct from EO and LO infections from GBS and other microorganisms.
2) To correlate patient experiences, we conducted a quasi-experimental “internet commons” inquiry of parent contacts who had suffered GBS SB.
3) Computer-based national data bases were utilized to assess knowledge of GBS infectious disease.

Results:
Much is known about GBS disease. Despite this knowledge, preventative regimes remain inconsistently applied, and in the best of circumstances are incompletely (85-90%) successful in reducing early-onset GBS infection and do not address late-onset or prenatal-onset GBS infections.

Conclusion:
1) There is sufficient knowledge supporting the Centers for Disease Control & Prevention (CDC) use of the term “prenatal-onset GBS disease” as a distinct entity.
2) Our limited, uncontrolled investigation supports clinical notions that a) GBS loss or SB occurs in a bimodal gestational time distribution with the preponderance of cases occurring near term (POGBS); and b) that mothers do not reliably demonstrate fever or “textbook” findings of potentially lethal intrauterine infection.

Ethics statement:
No patients were involved. No institutional consent required/obtained.

Leave a Comment