THE CARRIAGE AND PREVENTION OF VERTICAL TRANSMISSION OF GROUP B STREPTOCOCCUS IN PREGNANCY AT UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN

Abstract

BACKGROUND
Maternal Group B Streptococcus (GBS) vaginal and rectal carriage is an established risk to both
the pregnant woman, the fetus and the neonate. However, it has not received adequate attention
especially in developing countries where most health facility protocol for screening and
prevention of its vertical transmission is unavailable.
OBJECTIVES
To establish maternal vaginal and rectal group B Streptococcus carriage rate, determine risk
factors for colonization, associated perinatal events, evaluate a vertical transmission prevention
effort as well as to establish the antibiotic sensitivity and effectiveness among GBS carriers in
pregnant women attending antenatal care at University Of Ilorin Teaching Hospital (UITH),
Ilorin.
METHODOLOGY
A hospital-based cross-sectional study involving consenting booked pregnant women at 35-37
weeks gestational age at the study site. All participants had lower vaginal and rectal swabs taken
for culture and antibiotic sensitivity test optimized for GBS with availability of culture results
before the onset of labour. All GBS carriers had intrapartum parenteral antibiotics, administered
base on the sensitivity results. Mothers were evaluated for puerperal complications, while
neonatal follow-up for neonatal sepsis lasted for seven days.
RESULTS
A total of 166 pregnant women were recruited into the study with mean age 30.3±4.9 years. The
vaginal and rectal Group B Streptococcus carriage rate were 7.8% respectively and all vaginal
carriers were also rectal carriers. Maternal biosocial factors significantly related to GBS carriage were age (p=0.029), marital status (p=0.002), multiple sexual partner (p <0.001) and previous
sexually transmitted infection (p=0.013). Among GBS carriers 46.2% were single parent, 30.8%
were married, 15.4% were divorced while 7.7% were widowed. In terms of level of education,
23.1% had no formal education, 38.5% had primary education, 15.4% had secondary while
23.1% had tertiary levels of education. Group B Streptococcus isolates were 100% sensitive to
ampicillin and least sensitive to clindamycin (15.4%). There was no maternal morbidity and
vertical transmission of GBS was 0%.
CONCLUSION
Group B Streptococcus carriage among pregnant women was not rare and it was most sensitive
to ampicillin. Adequate intrapartum prophylaxis with ampicillin is effective in preventing
maternal and neonatal complications.