Streptococcal Infection in Pregnancy

In recent years, little progress has been achieved against perinatal group B streptococcus (GBS) infection. The bacteria remains a major cause of neonatal morbidity and mortality in the United States. Currently, the problem is managed through prophylactic antibiotic administration to highrisk women. Further progress against the disease awaits advances in immunology.

Since 1938, Group B streptococcus has been recognized as a human pathogen (Chapman, 1986, p. 404). Fry (1938) described 3 cases of puerperal sepsis involving the microorganism. More recently, GBS has been established as a major cause of infection in women and neonates. In general, bacterial species responsible for neonatal infection tend to exhibit geographic variation. Streptococci of Lancefield group B (species, Streptococcus agalactiae) are the predominant cause of neonatal invasive disease in the U.S. Indeed, in this country GBS is the most common cause of neonatal sepsis and purulent meningitis. Furthermore, despite the administration of antimicrobial therapies and improvements in intensive care, the outcome for this infection remains serious (Givner & Baker, 1988, p. 65). Thus, considerable attention has been focused upon the possibility of preventing GBS infections. Problems associated with GBS may include maternal chorioamnionitis and endomyometritis. This pathology results from ascending infection. Moreover, the maternal genital tract ma