title: Severe sepsis in women with group B Streptococcus in pregnancy: an exploratory UK national case-control study.
abstract: OBJECTIVE
  To estimate the incidence of severe maternal sepsis due to group B Streptococcus (GBS) in the UK, and to investigate the associated outcomes for mother and infant.
  
  
  METHODS
  National case-control study.
  
  
  METHODS
  All UK consultant-led maternity units.
  
  
  METHODS
  30 women with confirmed or suspected severe GBS sepsis, and 757 control women.
  
  
  METHODS
  Disease incidence, additional maternal morbidity, critical care admission, length of stay, infant infection, mortality.
  
  
  RESULTS
  The incidences of confirmed and presumed severe maternal GBS sepsis were 1.00 and 2.75 per 100,000 maternities, respectively, giving an overall incidence of 3.75 per 100,000. Compared with controls, severe GBS sepsis was associated with higher odds of additional maternal morbidity (OR 12.35, 95% CI 3.96 to 35.0), requiring level 2 (OR 39.3, 95% CI 16.0 to 99.3) or level 3 (OR 182, 95% CI 21.0 to 8701) care and longer hospital stay (median stay in cases and controls was 7 days (range 3-29 days) and 2 days (range 0-16 days), respectively, p<0.001). None of the women died. Severe maternal GBS sepsis was associated with higher odds of infant sepsis (OR 32.7, 95% CI 8.99 to 119.0); 79% of infants, however, did not develop sepsis. There were no associated stillbirths or neonatal deaths.
  
  
  CONCLUSIONS
  Severe maternal GBS sepsis is a rare occurrence in the UK. It is associated with adverse maternal and neonatal outcomes.
authors.affiliation: National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK.
authors.forename: Asli
authors.initials: A
authors.lastname: Kalin
authors.affiliation: National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK.
authors.forename: Colleen
authors.initials: C
authors.lastname: Acosta
authors.affiliation: National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Kurinczuk
authors.affiliation: Institute for Women's Health, University College London, London, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Brocklehurst
authors.affiliation: National Perinatal Epidemiology Unit (NPEU), University of Oxford, Oxford, UK.
authors.forename: Marian
authors.initials: M
authors.lastname: Knight
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000382:microbiology; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology; D013290:Streptococcal Infections / Q000453:epidemiology* / Q000382:microbiology; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D006113:United Kingdom / Q000453:epidemiology
keywords: PUBLIC HEALTH