Objective. To test the hypothesis that maternal obesity is an independent risk factor for rectovaginal group B streptococcus (GBS) colonization at term. Study Design. Retrospective cohort study of consecutive women with singleton term pregnancies admitted in labor at Barnes-Jewish Hospital (2004–2008). Maternal BMI ≥ 30 Kg/m2 (obese) or <30 Kg/m2 (nonobese) defined the two comparison groups. The outcome of interest was GBS colonization from a positive culture. Baseline characteristics were compared using Student's t-test and Chi-squared or Fisher's exact test. The association between obesity and GBS colonization was assessed using univariable and multivariable analyses. Results. Of the 10,564 women eligible, 7,711 met inclusion criteria. The prevalence of GBS colonization in the entire cohort was relatively high (25.8%). Obese gravidas were significantly more likely to be colonized by GBS when compared with nonobese gravidas (28.4% versus 22.2%, P < 0.001). Obese gravidas were still 35% more likely than nonobese women to test positive for GBS after adjusting for race, parity, smoking, and diabetes (adjusted OR 1.35 [95% CI 1.21–1.50]). Conclusion. Maternal obesity is a significant risk factor for GBS colonization at term. Further research is needed to evaluate the impact of this finding on risk-based management strategies.
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机译：目的。为了检验以下假设：产妇肥胖是足月直肠阴道B组链球菌（GBS）定植的独立危险因素。学习规划。在Barnes-Jewish医院接受分娩的连续单胎孕妇的回顾性队列研究（2004-2008年）。孕妇BMI≥30 Kg / m 2 （肥胖）或<30 Kg / m 2 （非肥胖）定义了两个比较组。感兴趣的结果是来自阳性培养物的GBS定植。使用学生t检验和卡方检验或Fisher精确检验比较基线特征。使用单变量和多变量分析评估了肥胖与GBS定植之间的关联。结果。在10 564名合格妇女中，有7 711名符合纳入标准。在整个队列中，GBS定植的患病率相对较高（25.8％）。与非肥胖妊娠孕妇相比，肥胖妊娠孕妇更容易被GBS定植（28.4％对22.2％，P <0.001）。调整种族，均等性，吸烟和糖尿病后，肥胖孕妇的GBS阳性率仍比非肥胖女性高35％（校正后的OR为1.35 [95％CI 1.21-1.50]）。结论。产妇肥胖是足月GBS定植的重要危险因素。需要进一步的研究来评估这一发现对基于风险的管理策略的影响。
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