title: A comparison of meningococcal carriage by pregnancy status.
abstract: Neisseria meningitidis is the second leading cause of invasive meningitis. A prerequisite for infection is colonization of the nasopharynx, and asymptomatic carrier rates are widely reported in the range of 10-15%. Recent reports have indicated an increased likelihood that a pediatric admission for Neisseria meningitidis will have a mother who is pregnant in the home. We hypothesized that this association may relate to immunologic changes in pregnancy leading to higher carrier rates.We compared the carrier status by performing nasopharyngeal swabs for Neisseria meningitidis in 100 pregnant and 99 non-pregnant women.Average age of the participants was 28.9 +/- 6.7 years. The average gestational age at specimen collection was 27.5 +/- 9.4 weeks. Non pregnant women were significantly more likely to use tobacco (38% vs 24%, p < 0.0001). In the entire 199 patients, only one pregnant patient tested positive for Neisseria meningitidis (0.5%; 95% CI: 0.01%-2.8%).The meningococcal carrier rate in our population is well below what is widely reported in the literature. Assuming a 1% carrier rate in the pregnant group and a 0.5% carrier rate in the non pregnant group, 4,763 patients would be required to detect a difference of this magnitude, given 80% power and an alpha of 0.05.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, The University of Oklahoma Health Sciences Center, PO Box 26901, WP 2470, Oklahoma City, OK 73160, USA. eknudtso@ouhsc.edu
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Knudtson
authors.forename: Mike L
authors.initials: ML
authors.lastname: Lytle
authors.forename: Beverly A
authors.initials: BA
authors.lastname: Vavricka
authors.forename: Valerie S
authors.initials: VS
authors.lastname: Skaggs
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Peck
authors.forename: Andrew E
authors.initials: AE
authors.lastname: Elimian
mesh_terms: D000328:Adult; D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006801:Humans; D008589:Meningococcal Infections / Q000453:epidemiology* / Q000382:microbiology*; D009345:Neisseria meningitidis / Q000502:physiology; D009825:Oklahoma / Q000453:epidemiology; D011247:Pregnancy