Perinatal complications in group B streptococcal carriers: a longitudinal study of prenatal patients.

Although prenatal group B streptococcal detection and eradication have been proposed to prevent morbidity, the risk of perinatal complications in prenatal carriers of group B streptococci has not been defined. We evaluated 718 prenatal patients with serial cultures to compare morbidity in carriers and noncarriers. Complications occurring more frequently (p less than or equal to 0.05) in prenatal carriers were: collective morbidity, low birth weight, and premature rupture of membranes associated with low birth weight. Maternal pelvic infection and neonatal sepsis were increased in colonized women at delivery but not in prenatal carriers. Ninety-two percent of colonized women were not delivered of low birth weight infants. No carriers delivered vaginally or by repeat cesarean section became infected. Neither inoculum size nor chronic carriage was related to morbidity. The predictive value of a positive prenatal culture did not exceed 8% for any of the complications. We concluded that overall morbidity in carriers of group B streptococci is greater than in noncarriers; however, the risk for specific complications is too low to justify routine testing for detection of group B streptococci until prospective study demonstrates the value of such programs.