To determine whether women with proven Group B Streptococcus (GBS) colonization undergoing cervical ripening with transcervical Foley catheter are at higher risk for maternal and neonatal infection.

Study Design: A retrospective cohort study including all women with singleton pregnancies and known GBS colonization status who underwent cervical ripening for labor induction with transcervical Foley catheter at a single tertiary medical center between 2011 and 2021. Infectious morbidity and other clinical outcomes were compared based on GBS colonization status. Primary outcome was defined as suspected neonatal sepsis based on criteria of the National Institute for Health and Care Excellence (NICE) clinical guidelines for the prevention and treatment of early-onset neonatal infection. Multivariable logistic regression explored the relationship between colonization with GBS to adverse outcomes while adjusting for relevant clinical variables.

Results:

A total of 4409 women were included, of whom 886 (20.1%) were considered colonized with GBS and 3523 (79.9%) were not. There was no difference in the rate of suspected neonatal sepsis between GBS carriers and non-carriers (5.2% vs. 5.0%, respectively, p=0.78). Confirmed neonatal sepsis was diagnosed in 7 (0.02%) cases, all born to mothers who had a negative GBS culture. Maternal bacteremia was more common among GBS carriers compared to non-carriers (1.2% vs. 0.5%, respectively, p=0.01). In multivariable analysis, GBS colonization was independently associated with maternal bacteremia (adjusted odds ratio 3.05; 95% CI 1.39, 6.66).

GBS colonization does not seem to increase the risk for neonatal infection among women undergoing cervical ripening with transcervical Foley catheter. Nevertheless, higher rates of maternal bacteremia were observed among women colonized with GBS.