The spectrum of perinatal group B streptococcal disease

The progressive unfolding, over four decades, of an understanding of group B Streptococcus (GBS) and its global disease burden support the rationale for maternal immunization as a key strategy to prevent GBS perinatal infections. This review highlights, in historical context, the recognition of GBS as a human pathogen, definition of epidemiologic features of disease, pathogenesis, outcomes, impact of intrapartum antibiotic prophylaxis, development of glycoconjugate vaccines and appreciation of the global scope of GBS perinatal disease. These cumulative advances in the GBS field coupled with an increasing acceptance of immunization during pregnancy suggest the timing is optimal for introduction of a glycoconjugate GBS vaccine for use in pregnant women.

► GBS contributes substantially to global mortality, morbidity and permanent neurological sequelae in infants less than 3 months of age.
► GBS contributes substantially to global maternal pregnancy-associated morbidity.
► A maternal GBS glycoconjugate vaccine would reduce young infant deaths, hospitalizations and outcomes as well as pregnancy-associated adverse events.