Maternal vaginal flora during labor and its effect on gestational age and birthweight of neonates


  • Vidya Singaravelu Department of Pediatrics, DM Wayanad Institute of Medical Sciences, Naseeranagar, Meppadi, Wayanad, Kerala, India



Gestational age, Maternal vaginal flora, SGA babies, Vaginal colonization


Background: Identification of the abnormal colonization of the genital tract by a culture based approach has been recommended by the CDC 2000. This will definitely aid in the early recognition of mothers who need to be effectively treated which in turn will prevent newborn infections. Objectives were to study the pattern of maternal vaginal flora in labor and to study the outcome in the neonate.

Methods: This study was conducted on 250 mothers in labor and their babies followed up till discharge in the departments of OBG and neonatology in a tertiary care medical college hospital, Deliveries by caesarean section were excluded.

Results: Of the 250 babies, 70 were small for gestational age (SGA) and of these 60 (85.71%) were born to colonized mothers; whereas among the appropriate for gestation (AGA) babies, 110 (61.11%) were those born to non-colonised mothers. A statistically significant association was found between SGA babies and maternal colonization. Whereas relation between maternal colonization and gestational age did not show a statistically significant difference.

Conclusions: This study shows us that maternal vaginal colonisation in labor significantly impacted the baby's weight with increase in small for gestational age babies being more among the colonised mothers. Hence, finding the organism in the maternal vaginal flora and treating it as per sensitivity might result in lesser incidence of SGA babies.


Stoll BJ, Hanson N, Fanaroff AA, Wright LL, Carlo WA, Ehrenkranz RA et al. Late-onset sepsis in very low birth weight neonates: The experience of the NICHD Neonatal Research Network. Pediatrics. 2002;110(2 Pt 1):285-91.

Squire E, Favara B, Todd J. Diagnosis of neonatal bacterial infection: hematologic and pathologic findings in fatal and nonfatal cases. Pediatr. 1979;64:60-4.

Hall SL, Hall RT, Barnes WG. Relationship of maternal to neonatal colonization with coagulase-negative staphylococci. Am J Perinatol. 1990;7(4):384-8.

Ayengar V, Madhulika, Vani SN. Neonatal sepsis due to vertical transmission from maternal genital tract. Indian J Pediatr. 1991;58:661-4.

Stoll BJ, Schuchat A. Maternal carriage of group B streptococci in developing countries. Pediatr Infect Dis J. 1998;17(6):499-503.

Singh M, Deorari AK. Pneumonias in newborn babies. Indian J Pediatr. 1995;62:293-306.

Tsolia M, Psoma M, Gavrili S, Petrochilou V, Michalas S, Legakis N, et al. Group B streptococcus colonization of Greek pregnant women and neonates:prevalence, risk factors and serotypes. Clin Microbiol Infect. 2003;9:832-8.

Kataoka S, Yamada T, Chou K, Nishida R, Morikawa M, Minami M, et al. Association between preterm birth and vaginal colonization by mycoplasmas in early pregnancy. J Clin Microbiol. 2006;44(1):51-5.

Hillier SL, Krohn MA, Kiviat NB, Watts DH, Eschenbach DA. Microbiologic causes and neonatal outcomes associated with chorioamnion infection. Am J Obstet Gynecol. 1991;165:955-61.

Krohn MA, Thwin SS, Rabe LK, Brown Z, Hillier SL. Vaginal colonization by Escherichia coli as a risk factor for very low birth weight deliveries and other perinatal complications. Pediatr Infect Dis J. 1997;175:606-10.

Matee MI, Massawe FA, Lyamuya EF. Maternal and neonatal colonisation of group B streptococcus at Muhimbili National Hospital in Dar es Salaam, Tanzania: prevalence, risk factors and antimicrobial resistance. BMC Public Health. 2009 Dec 1;9(1):437.

Ali GY, Algohary EH, Rashed KA, Almoghanum M, Khalifa AA. Prevalence of Candida colonization in preterm newborns and VLBW in neonatal intensive care unit: role of maternal colonization as a risk factor in transmission of disease. J Matern Fetal Neonatal Med. 2012 Jun;25(6):789-95.






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