Group B Streptococcus maternal colonization and respiratory infections in the offspring: lessons learned from an analysis of a population-based cohort with 18-year follow-up

  • Shirley GreenbaumEmail author
  • Eyal Sheiner
  • Tamar Wainstock
  • Idit Segal
  • Ruslan Sergienko
  • Asnat Walfisch
Maternal-Fetal Medicine



Group B Streptococcus (GBS) early onset disease is a major cause for neonatal morbidity and mortality. We aimed to determine whether maternal GBS and the associated intrapartum antibiotic prophylaxis impacts pediatric long-term respiratory infectious morbidity.

Study design

A population-based cohort study was conducted, during the years 1991–2013, comparing the incidence of hospitalizations due to common respiratory infections (RI) in offspring of mothers with and without GBS. Univariate analysis and a Cox proportional hazard model were used to estimate un-adjusted and adjusted hazard ratios for pediatric RI risk.


During the study period, 173,757 term vaginal deliveries took place, of which 2.4% (4252) were diagnosed as GBS + gravidas. In univariate and multivariate analyses for the entire study period, RI risk was increased in exposed offspring. In a sensitivity analysis investigating study periods with different health policies, both GBS diagnosis rates and pediatric infectious respiratory morbidity rates increased over time, but with no independent association between the two.


When analyzing large data sets spanning over long time periods, a special attention must be paid to account for healthcare trends, to avoid erroneous conclusions, as demonstrated here.


Intrapartum antibiotic prophylaxis (IAP) Health care policy Diagnosis trends 


Author contributions

GS conceived the idea and wrote the first draft with substantial contributions from SE and WA. GS, SE, WT, SI, SR, and WA planned and carried out the analyses. WA supervised the project. All authors listed have approved the final version.

Compliance with ethcial standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethics approval

The study was approved by the local Institutional Review Board (SUMC IRB #0438–15-SOR approved on March 8th 2016).

Informed consent

Due to study design, a waiver of informed consent was granted by the Institutional Review Board (SUMC IRB #0438–15-SOR approved on March 8th 2016).

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and Gynecology, Soroka University Medical CenterBen-Gurion University of the NegevBeer-ShevaIsrael
  2. 2.Department of Pathology, School of MedicineStanford UniversityStanfordUSA
  3. 3.Department of Public Health, Faculty of Health SciencesBen-Gurion University of the NegevBeer-ShevaIsrael
  4. 4.Ministry of HealthJerusalemIsrael

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