Intrauterine Death Due to Infection with Group B Streptococci

Bergqvist, Gudmund; Holmberg, Gunnar; And, T. Rydner; Václavínková, V.

doi:10.3109/00016347809155890

Cited by 24 publications

(12 citation statements)

References 8 publications

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“…30 The reported rates across Swedish studies from the 1970s and 1980s were highly consistent (0.2-0.3 per 1000 births). 19,21,22,24 Additionally, data from 11 studies suggested that the proportion of GBS among infection-related stillbirth ranged from 0 to 50%.…”

Section: Gbs-related Stillbirthmentioning

confidence: 99%

“…Of the 17 included publications, ten studies were conducted before 1990, five in the 1990s, and only two were conducted since 2000. Five reports were identified from Sweden, 19,21,22,24,35 four from the USA, 23,29,30,34 two from Canada, 25,26 and one each from Zimbabwe, 33 Mozambique, 28 Lithuania, 31 Italy, 32 England, 27 and New Zealand. 20 A variety of different study designs were used, including three case-control studies, eight prospective cohort studies, and five retrospective reviews of autopsy files.…”

Section: Literature Searchmentioning

confidence: 99%

“…22,28 Details on gestational age were primarily related to the stillbirth definition used in studies. Nine studies included stillbirths occurring before 28 weeks of gestation, and six reported only stillbirths occurring at ≥28 weeks of gestation.…”

Section: Gbs-related Stillbirthmentioning

confidence: 99%

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Maternal group B Streptococcus‐related stillbirth: a systematic review

Nan¹,

Dangor

Cutland

et al. 2015

BJOG

126

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Background Limited epidemiological data on the association between maternal rectovaginal group B Streptococcus (GBS) colonisation and stillbirth makes assessment of antenatal interventions for GBS stillbirth difficult.Objectives To systematically review the existing literature and evaluate the incidence of GBS-related stillbirth by region up to March 2015.Search strategy A systematic review of the published literature was completed using PubMed/MEDLINE, EMBASE, LILACS, and Cochrane Library, with Medical Subject Headings (MeSH) and search terms based upon the Centers for Disease Control and Prevention's (CDC) Active Bacterial Core Surveillance (ABCs) GBS-related stillbirth definition and chorioamnionitis.Selection criteria Studies reporting original data on GBS-related stillbirth occurring ≥20 weeks of gestation, with GBS confirmed by autopsy or by culture from the placenta, amniotic fluid, or other normally sterile site samples from the stillborn.Data collection and analysis Descriptive analyses were performed with the absolute GBS-related stillbirth rates and proportion of stillbirths attributed to GBS calculated per study where possible. Differences in stillbirth definitions did not allow for pooled estimates to be calculated.Main results Seventeen studies reported GBS-related stillbirth rates varying from 0.04 to 0.9 per 1000 births, with the proportion of stillbirths associated with GBS ranging from 0 to 12.1%. Most studies reported data from before the year 2000 and from highincome countries.Conclusions The sparsely available epidemiological evidence was not reported consistently, emphasising the importance of standardised stillbirth definitions and diagnostic methods to optimally assess the effectiveness of any future antenatal interventions. Timing of stillbirth, GBS serotype, and global diversity were gaps in the current evidence.

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Section: Gbs-related Stillbirthmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

See 1 more Smart Citation

Maternal group B Streptococcus‐related stillbirth: a systematic review

Nan¹,

Dangor

Cutland

et al. 2015

BJOG

126

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“…Moreover, other human pathogens including parvovirus B19, which can cause intrauterine fetal death, have been linked with erythroblast apoptosis [50]. Interestingly, intrauterine fetal death has also been strongly associated with GBS infections [3, 51, 52]. These observations suggest that GBS-induced erythroblast apoptosis may play a role GBS-associated intrauterine fetal death.…”

Section: Discussionmentioning

confidence: 99%

Group B Streptococcus induces a caspase-dependent apoptosis in fetal rat lung interstitium

Kling

Tsvang

Murphy

et al. 2013

Microbial Pathogenesis

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Group B Streptococcus (GBS) is an important pathogen and is associated with sepsis and meningitis in neonates and infants. An ex vivo model that facilitates observations of GBS interactions with multiple host cell types over time was used to study its pathogenicity. GBS infections were associated with profound reductions in fetal lung; explant size, and airway branching. Elevated levels of apoptosis subsequent to GBS infections were observed by whole-mount confocal immunofluorescence using activated-caspase-3-antibodies and terminal deoxynucleotidyl transferase dUTP nick end-labeling (TUNEL) assays. The caspase inhibitor Z-VAD-FMK abolished the increase in TUNEL-positive cells associated with GBS infections, indicating that the GBS-induced apoptosis was caspase-dependent. Digital image analyses revealed that both GBS and the active form of caspase-3 were distributed primarily within the lung interstitium, suggesting that these tissues are important targets for GBS. Antibodies to the active form of caspase-3 colocalized with both macrophage- and erythroblast-markers, suggesting that these hematopoietic cells are vulnerable to GBS-mediated pathogenesis. These studies suggest that GBS infections profoundly alter lung morphology and caspase-dependent hematopoietic cell apoptosis within the lung interstitium play roles in GBS pathophysiology in this model.

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“…The pathogenesis of early-onset infection in human neonates born to colonized mothers with intact or recently ruptured membranes could be similar to that occurring in this animal model. Hematogenous transmission of GBS from mother to infant has been suspected as occurring, particularly in the presence of intact membranes (8). The importance of this mode of transmission of infection, however, is not well understood.…”

Section: Discussionmentioning

confidence: 99%

Newborn Sepsis following Antepartum Group B Streptococcal Maternal Infection in Rats

1985

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27. Rovamo L, Nikkila EA, Taskinen MR, Raivio KO 1984 sepsis in the rat has been established (5) and GBS surface colonization of pups born to mothers colonized with GBS has been demonstrated (6), a model in the rat that involves newborn sepsis resulting from maternal colonization of infection has not been described. The purpose of this study was to develop an animal model of vertical transmission of newborn sepsis following group B streptococcal challenge of mothers. A better understanding of the mechanisms of transmission of GBS and the pathogenesis of early-onset neonatal sepsis may help in our approach to new prophylactic and therapeutic regimens. MATERIALS AND METHODS Preparation of organisms.A human isolate of GBS type I11 further characterized as resistant to opsonization (7) was incubated in Todd-Hewitt broth (Difco Labs) at 37" C for 18 h and adjusted to 10'-10' CFU/ml in normal saline.Animals. Pregnant outbred Sprague-Dawley rats (Charles River Labs) of 15-18 days gestation were obtained and housed in our animal quarters. On day 20 or 21 of gestation animals were given 2 ml of GBS inoculum (109-1010 C N ) ip through a 25-gauge needle in the right upper quadrant of the abdomen. Care was taken not to inoculate viscera or uterus. Blood cultures obtained by incising the distal tail were taken at 2, 24, 48, and 72 h following inoculation. Animals were closely observed and time of delivery was recorded. Soon after birth, and at regular intervals during the first 48 h of life, pups were sacrificed and cultures were obtained.Isolation of GBS. Cultures were obtained from all dead adult females, stillborns, and sacrificed pups.Blood for culture was obtained by aseptic intracardiac puncture with a 25-gauge needle attached to a tuberculin syringe and inoculated onto blood agar plates which were incubated overnight at 37" C.Brain specimens were obtained by aseptic puncture of the cranium and aspiration with a 21-gauge needle attached to a tuberculin syringe. Brain tissue was inoculated onto blood agar plates and incubated.Liver and spleen were aseptically removed from each animal upon opening the abdominal cavity. Care was taken not to incise the bowel or stomach and minimal bleeding was appreciated

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Intrauterine Death Due to Infection with Group B Streptococci

Cited by 24 publications

References 8 publications

Maternal group B Streptococcus‐related stillbirth: a systematic review

Maternal group B Streptococcus‐related stillbirth: a systematic review

Group B Streptococcus induces a caspase-dependent apoptosis in fetal rat lung interstitium

Newborn Sepsis following Antepartum Group B Streptococcal Maternal Infection in Rats

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