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

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.

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.

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.

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.

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