LAUSR

1 Group B strep and associated complications in cesarean delivery A. M. Wood, B. L. Hughes, R. P. Heine, M. S. Villers Duke University Medical Center, Durham, NC OBJECTIVES: The objective of this study is to determine the effect of Group B streptococcus (GBS) on maternal infectious complications in women undergoing cesarean delivery (CD) in an era of routine GBS antibiotic prophylaxis during labor. METHODS: Retrospective cohort of women undergoing CD during labor at 37 weeks gestation or greater from January to December 2014. Intrapartum and postpartum complications were compared between women without GBS and those with a positive culture or unknown GBS status. Routine pre-operative antibiotics were used for all women. Labor at time of cesarean was documented by physician notes. Univariate analysis was performed using chi-square and Mann-Whitney U tests. A logistic regression analysis was then performed to control for potential confounders. RESULTS: 398 women had complete data and were included. 255 women (64%) were GBS negative, and 143 were GBS positive or unknown (36%). Compared to GBS negative women, GBS positive women were had a higher BMI and parity, and lower gestational age at delivery. They were less likely to have private insurance or be of white race. They had an increased incidence of gestational diabetes or hypertensive disorders of pregnancy. There were no significant differences in length of rupture of membranes, reported penicillin allergies, or surgical technique. In univariate analysis, women with GBS were noted to have a significantly lower incidence of clinical chorioamnionitis (5% vs 18%, p1⁄40.001). There were no differences in rates of endometritis or wound infection. In adjusted analysis for the outcome chorioamnionitis, women with GBS had a decreased risk of chorioamnionitis (aOR 0.17, 95% CI 0.07, 0.44). CONCLUSIONS: Within our cohort, women who were GBS positive and underwent CD in labor had a significantly lower risk of chorioamnionitis than women who were GBS negative. There were no significant differences in other postpartum infectious complications.