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



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Submitted Jul 28, 2022
Published Nov 9, 2022
10.24018/ejmed.2022.4.6.1452

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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.

Keywords: C-Reactive Protein, Group B Streptococcus infection, Preterm delivery

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References

  1. World Health Organization. Preterm Birth. WHO. 2018.
     Google Scholar
  2. Gauthama IMPS, Negara IKS. Characteristics of Preterm Birth Cases at Sanglah Hospital Denpasar. International Journal of Science and Research. 2017; 6(7): 2248-5.
    DOI  |   Google Scholar
  3. Intan TS. “Karakteristik Ibu yang Melahirkan Bayi Premtur di Rumah Sakit Santa Elisabeth Medan Tahun 2004 – 2008” (Skripsi). Medan: FKM USU; 2009.
     Google Scholar
  4. Darah I. “Hubungan Antara Preeklampsia Dengan Prematuritas Di RSUD Pandan Arang Boyolali, Surakarta” (Skripsi). Surakarta: Universitas Sebelas Maret. DepKesRI. 2008. Riset Kesehatan Dasar (RISKESDAS) 2007.
     Google Scholar
  5. Oroh S, Suparman E, Tendean HMM. Karakteristik Persalinan Prematur di RSUP Prof. Dr. R. D. Kandou Manado. Jurnal e-Clinic (eCl). 2015; 3(2). Indonesian.
    DOI  |   Google Scholar
  6. Sungkar A, Fattah ANA, Surya R, Santoso BI, Zalud I. High Preterm Birth at Cipto Mangun kusumo Hospital as a National Referral Hospital in Indonesia. Med J Indones. 2017; 26(3). Indonesian.
    DOI  |   Google Scholar
  7. Ardhana IK, Suwardewa TGA, Widarsa KT. Perbandingan efektifitas magnesium sulfat dan ritodrine untuk menghambat proses persalinan prematur di RSUP Sanglah Denpasar (tesis). Denpasar: Universitas Udayana; 1999. Indonesian.
     Google Scholar
  8. Udiarta W, Suwardewa TGA. Profil Persalinan Preterm di RS Sanglah Periode Januari 2001 sampai Desember 2003. Lab/SMF Obstetri Ginekologi RS Sanglah Denpasar. 2004. Indonesian.
     Google Scholar
  9. Cunningham FG, Leveno KJ, Bloom SL. Preterm Labor, William Obstetric 24th Edition. McGraw-Hill Education, 2014: 829-861.
     Google Scholar
  10. Greenberg JM, Narendran V, Schibler KR. Neonatal Morbidities of Prenatal and Perinatal Origin. Dalam: Creasy & Resnik’s Maternal-Fetal Medicine: Principles and Practice 7th Edition. Elsevier Inc; 2014: 215-39.
     Google Scholar
  11. Buhimschi CS, Norman, JE. Pathogenesis of Spontaneous Preterm Birth, Dalam: Creasy & Resnik’s Maternal-Fetal Medicine: Principles and Practive 7th Edition, Elsevier Inc, 2014: 599-623.
     Google Scholar
  12. Menon R. Spontaneous preterm birth, a clinical dilemma: Etiologic, pathophysiologic and genetic heterogeneities and racial disparity. Acta Obstet Gynecol Scand. 2010: 590-600.
    DOI  |   Google Scholar
  13. Romero R, Espinoza J, Gancalves L, Kusanovic JP, Friel L, Hassan S. The Role of Inflammation and Infection in Preterm Birth. Semin Reprod Med. 2007; 25(1): 021-039.
    DOI  |   Google Scholar
  14. Gomez LM, Ma Y, Ho C, McGrath CM, Nelson DB, Parry S. Placental infection with human papillomavirus is associated with spontaneous preterm delivery. Hum Reprod. 2008; 23(3): 709-15.
    DOI  |   Google Scholar
  15. Cunningham FG, Gant NF, Leveno KJ. Premature Rupture of Membrane. Williams Obstetrics. 21st edition, 2001: 699-707.
     Google Scholar
  16. Escenbach DA. Prevention of Neonatal Group B Streptococcal Infection. The New Eangland Journal of Medicine. 2002; 347: 280-1.
    DOI  |   Google Scholar
  17. Griffin MP, Moorman JR. Toward the Early Diagnosis of Neonatal Sepsis and Sepsis like illness using Novel Heart-rate Analysis. Pediatrics. 2001; 107: 97-104.
    DOI  |   Google Scholar
  18. Benitz WE, Gould JB, Druzin ML. Antimicrobial Prevention of Early-onset Group B Streptococcal Sepsis Estimates Risk Reduction Based on Critical Literature Review. Pediatrics. 1999; 103: 123-8.
    DOI  |   Google Scholar
  19. Regan JA, Klebanoff MA, Nugent RP, Eschenbach DA, Blackwelder WC, Lou Y, et al. Colonization with Group B Streptococci in Pregnancy and Adverse Outcome. Am J Obstet Gynecol. 1996; 174: 1354-60.
    DOI  |   Google Scholar
  20. Bianchi-Jassir F, Seale AC, Kohli-Lynch M, Lawn JE, Baker CJ, Bartlett L, et al. Preterm Birth Associated with Group B Streptococcus Maternal Colonization Worldwide: Systematic Review and Meta-analyses. Clin Infect Dis. 2017; 65(suppl 2): S133-S142.
    DOI  |   Google Scholar
  21. Senthil S, Dhamayanthi S. Measurement of serum C-reactive protein levels in early second trimester as a predictor of preterm delivery. Int J Reprod Contracept Obstet Gynecol. 2019: 4946-50.
    DOI  |   Google Scholar
  22. Shahshahan Z, Rasouli O, The use of maternal C-reactive protein in the predicting of preterm labor and tocolytic therapy in preterm labor women. Adv Biomed Res. 2014.
    DOI  |   Google Scholar
  23. Hvilsom GB, Thorsen P, Jeune B, Bakketeig LS. C-reactive protein: a serological marker for preterm delivery. Acta Obstetricia et Gynecologica Scandinavica. 2002.
    DOI  |   Google Scholar
  24. Panduan Praktek Klinis Persalinan Preterm. PPK OBGYN. SMF Obstetri & Ginekologi RSUP Sanglah. 2015: 90-4.
     Google Scholar
  25. Patras KA, Nizet V. Group B Streptococcal maternal colonization and neonatal disease: Molecular mechanisms and preventative approaches. Frontiers in Pediatrics. 2018; 6: 1–17.
    DOI  |   Google Scholar
  26. Howman RA, Charles AK, Jacques A, Doherty DA, Simmer K, Strunk T, et al. Inflammatory and Haematological Markers in the Maternal, Umbilical Cord and Infant Circulation in Histological Chorioamnionitis. PLoS ONE. 2012; 7(12).
    DOI  |   Google Scholar
  27. Broumand F, Naji S, Seivani S. Predictive values of maternal serum levels of procalcitonin, ESR, CRP, and WBC in the diagnosis of chorioamnionitis in mothers with preterm premature rupture of membrane. Iranian Journal of Neonatology. 2018; 9(2): 50–60.
     Google Scholar
  28. Koullali B, Van Zijl MD, Kazemier BM, Oudijk MA, Mol BWJ, Pajkrt E, et al. The association between parity and spontaneous preterm birth: A population based study. BMC Pregnancy and Childbirth. 2020; 20(1): 1–8.
    DOI  |   Google Scholar
  29. Sri BN, Hariyasa SN. Group-B Streptococcus in Pregnant: Prevalence of Colonization and Sensitivity Pattern in Denpasar during June 2007-May 2008. Bali Medical Journal (BMJ). 2013; 2(1): 17-20.
     Google Scholar
  30. Ren J, Qiang Z, Li Y, Zhang J. Biomarkers for a histological chorioamnionitis diagnosis in pregnant women with or without group B streptococcus infection: a case-control study. BMC Pregnancy and Childbirth. 2021; 21: 250.
    DOI  |   Google Scholar
  31. Huang J, Li S, Li L, Wang X, Yao Z, Ye X. Alarming regional differences in prevalence and antimicrobial susceptibility of group B streptococci in pregnant women: a systematic review and meta-analysis. J Glob Antimicrob Resist. 2016; 7: 169–77.
    DOI  |   Google Scholar
  32. Tann CJ, Martinello KA, Sadoo S, Lawn JE, Seale AC, Vega-Poblete M. Neonatal encephalopathy with group B streptococcal disease worldwide: systematic review, Investigator Group datasets, and metaanalysis. Clin Infect Dis. 2017; 65: S173–S89.
    DOI  |   Google Scholar
  33. Seale AC, Blencowe H, Bianchi-Jassir F, Embleton N, Bassat Q, Ordi J. Stillbirth with group B Streptococcus disease worldwide: systematic review and meta-analyses. Clin Infect Dis. 2017; 65: S125-S32.
    DOI  |   Google Scholar
  34. Bellig LL, Ohning BL, MacGilvray S. Neonatal Sepsis. eMedicine. 2005: 1298-305.
     Google Scholar
  35. Philips GS. Group B Streptococcus in Neonatal Sepsis: Emergence as an Important Pathogen, Historical Perspective. Neo Reviews. 2004: 467-470.
     Google Scholar
  36. Smith TC. Deadly diseases and epidemics of streptococcus Group B. 2007: 15-20.
     Google Scholar
  37. Baratawidjaja K, Rengganis I. Imunologi dasar. Jakarta: Balai Penerbit Fakultas Kedokteran Universitas Indonesia; 2010. Indonesian.
     Google Scholar


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