Group B streptococcus infection rate unchanged by gestational diabetes

Objective: Group B streptococcal colonization in pregnancy has been associa ted with adverse perinatal outcomes, including intra-amniotic infection, po stpartum endometritis, and neonatal sepsis. We sought to determine whether gestational diabetes increases the risk of maternal and neonatal morbidity from group B streptococcal colonization. Methods: Gestational diabetic and nondiabetic women who underwent vaginal o r anogenital culture for group B streptococcus colonization in pregnancy we re followed up for pregnancy outcome. Antibiotic prophylaxis was not routin ely given. Major perinatal morbidity included intraamniotic infection, endo metritis, and neonatal sepsis. Potential confounding variables included ind uction of labor, cesarean delivery, prematurity, maternal antibiotic use, a nd prolonged rupture of membranes. Results: We compared 446 gestational diabetic women to 1,046 nondiabetic wo men for outcome. Overall, 12% were colonized with group B streptococcus, wi th no difference in colonization rates between gestational diabetic (12%) a nd nondiabetic (12%) women. There were no differences in intraamniotic infe ction rates between gestational diabetic and nondiabetic women, whether gro up B streptococcus positive (16% compared with 13%) or group B streptococcu s negative (10% compared with 11%). Likewise, endometritis did not differ ( 6-9%) regardless of diabetes or group B streptococcus status. Neonatal seps is was higher in group B streptococcus-positive women overall (3% compared with 1%, odds ratio 3.71, 95% confidence interval 1.23, 10.81), but did not differ between diabetic and nondiabetic pregnancies. Conclusion: Gestational diabetes does not alter the perinatal morbidity ass ociated with group B streptococcal colonization in pregnancy. (Obstet Gynec ol 1999;93:292-6. (C) 1999 by The American College of Obstetricians and Gyn ecologists.).