GBS as a Cause of Preterm Labor & (P)PROM

9/24/2018

Presented by David M. Aronoff, MD, FIDSA, FAAM

Measurable Learning Objectives:
At the conclusion of this presentation, participants should be able to…
1. Explain how GBS ascends into the uterus
2. Discuss the possible results of chorioamnionitis pathogenesis
3. Discuss that the uterus is not a sterile environment

ABOUT THE PRESENTER:

David M. Aronoff, MD, FIDSA, FAAM
Dr, David Aronoff is the Director of the Division of Infectious Diseases at the Vanderbilt University School of Medicine and the founding Director of the Vanderbilt Pre3 Initiative (Preventing adverse Pregnancy outcomes and Prematurity). He is also the Addison B Scoville, Jr Chair in Medicine and is on Group B Strep International’s Board of Directors. The Aronoff Lab studies reproductive immunology and host-microbial interactions in the context of pregnancy, with a focus on Group B Streptococcus (GBS) infections. Primary areas of focus include mechanisms of disease pathogenesis involved in GBS infections causing chorioamnionitis, preterm birth, stillbirth and neonatal sepsis.

Kelli Smith

10/15/2018 05:10:01 am

Dr. Aronoff,
Thank you for your continued work and dedication to GBS. Your slide on Intrapartum Evidence of Early-Onset GBS really stuck with me. Does this study state what the mothers GBS results were? I’m interested if all 94 babies had GBS positive mothers or if any had negative GBS cultures.
Do you think it will be possible/feasible for hospitals to culture newborns who are born from a mother who tested negative during pregnancy? If parents were educated prior about GBS and began to notice signs of baby in distress potentially they could push for a culture.
Thank you.

David Aronoff

10/15/2018 06:54:47 pm

Thank you so much for your note. That 2012 Tudela study was really interesting. Unfortunately for all of us, mothers were not cultured for GBS carriage prior to delivery. Per the authors, "Antepartum GBS cultures were not performed." In terms of your other question, I think it would be feasible for hospitals to culture babies born to GBS-negative mothers but probably only if those babies had signs of infection. If all babies born to GBS-negative mothers were cultured for GBS I would think a lot of babies would need to be cultured to identify culture-positive newborns. That would be an interesting problem to model. Thanks for the questions!.

Marti Perhach

10/23/2018 12:55:32 pm

Thank you for such an excellent explanation of how intrauterine GBS can cause adverse pregnancy outcomes. In the future, do you think that technology could be used to better define the microbiome of the uterus at the time of c-section?

10/23/2018 12:58:17 pm

Possibly! Surveying the human microbiome is heading towards clinical diagnostic lab use, but is not really there yet, at least not with a rapid turnaround. We would also need some clinical studies to show that profiling the uterine microbiome can improve maternal or neonatal health. That will be critical before anything gets into clinical use. Thanks for the question!

Comments are closed.