Abstract 14: Group B Streptococcal Colonization - A Silent Threat to Feto-maternal Wellbeing

Abstract Background: Group B Streptococcus (GBS), caused by Streptococcus agalactiae , is a Gram-positive commensal of the gastrointestinal and genitourinary tracts. Approximately 10–30% of women are asymptomatic carriers, with vaginal and/or rectal colonisation posing a major risk during pregnancy. Maternal colonisation is associated with preterm labour, pre-labour rupture of membranes (PROM), postpartum infections, and neonatal complications such as sepsis, meningitis, stillbirth, and death. Aim: To determine the prevalence of GBS colonisation in late pregnancy and evaluate associated maternal and neonatal outcomes. Methods: A prospective observational study was conducted from 2023–2025 in the Departments of Obstetrics and Gynaecology, Paediatrics, and Microbiology at Jawaharlal Nehru Medical College Hospital, Aligarh. Recto-vaginal swabs were collected from healthy antenatal women at 35–37 weeks and cultured on HiCrome StrepB selective agar with GCN supplement. Blue colonies were identified as GBS. Women testing positive received intrapartum antibiotic prophylaxis (IAP) with ampicillin, or cefazolin/vancomycin if penicillin-allergic. Maternal and neonatal outcomes were assessed in terms of PROM/PPROM, urinary tract infections, surgical site infections (SSI), postpartum infections, stillbirth, neonatal sepsis, NICU admission, and hospital stay. Results: GBS colonisation was detected in 66.49% of women. PROM was significantly higher in GBS-positive women (9.3%) compared with GBS-negative women (7.69%, p=0.03). Episiotomy site infection (6.2% vs 3.08%) and SSI (13.95% vs 7.69%) were more frequent in the GBS-positive group. NICU admission rates were comparable due to effective IAP. Mean hospital stay was longer in GBS-positive women (5.88 vs 4.89 days). Conclusion: Given the high prevalence of GBS colonisation and its association with maternal morbidity, routine antenatal screening at 35–37 weeks and timely IAP should be endorsed to reduce feto-maternal complications and improve neonatal outcomes.