Postpartum Group A Streptococcus Sepsis and Maternal Immunology

• Published in: American journal of reproductive immunology (1989) Vol. 67; no. 2; pp. 91 - 100
• Main Authors: Mason, Katie L., Aronoff, David M.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.02.2012
• Subjects: Cesarean section; Female; Female reproductive tract; Genitalia, Female - microbiology; Group A Streptococcus; Hospitals; Humans; Hygiene; Immune response; Immune status; maternal immunology; Morbidity; Mortality; Postpartum; Postpartum Period - immunology; postpartum sepsis; Pregnancy; Puerperal infection; Puerperal Infection - immunology; Puerperal Infection - microbiology; Reproductive system; Reproductive Tract Infections - immunology; Reproductive Tract Infections - microbiology; Sepsis; Sepsis - microbiology; Streptococcal Infections - epidemiology; Streptococcal Infections - microbiology; Streptococcus; Streptococcus pyogenes - immunology; Streptococcus pyogenes - pathogenicity; Vagina; Virulence
• ISSN: 1046-7408; 1600-0897
• DOI: 10.1111/j.1600-0897.2011.01083.x

Citation Mason KL, Aronoff DM. Postpartum group A Streptococcus sepsis and maternal immunology. Am J Reprod Immunol 2012; 67: 91–100 Group A Streptococcus (GAS) is an historically important agent of puerperal infections and sepsis. The inception of hand‐washing and improved hospital hygiene drastically reduced the incidence of puerperal sepsis, but recently the incidence and severity of postpartum GAS infections has been rising for uncertain reasons. Several epidemiological, host, and microbial factors contribute to the risk for GAS infection and mortality in postpartum women. These include the mode of delivery (vaginal versus cesarean section), the location where labor and delivery occurred, exposure to GAS carriers, the altered immune status associated with pregnancy, the genetic background of the host, the virulence of the infecting GAS strain, and highly specialized immune responses associated with female reproductive tract tissues and organs. This review will discuss the complicated factors that contribute to the increased susceptibility to GAS after delivery and potential reasons for the recent increase observed in morbidity and mortality.