Maternal and neonatal outcomes of membrane stripping in rural canadian group B Streptococcus-colonized pregnancies

Abstract

Objective

This study aimed to evaluate the safety of membrane sweeping in Group B Streptococcus-positive pregnancies by assessing maternal and neonatal surrogate outcomes in a rural, midwifery-led birth center.

Methods

A retrospective chart review was conducted for 67 Group B Streptococcus-positive pregnant women under midwife care—31 who received membrane stripping and 36 who did not—were analyzed using data from the birth center’s database and Medesync hospital records.

Results

No early-onset neonatal Group B Streptococcus cases were reported. Membrane stripping showed no association with intrapartum transfers (p > 0.99) or reasons for transfer (p = 0.13). Apgar scores at 1, 5, and 10 min were unaffected (p = 0.37, 0.81, 0.80). Mean gestational age was higher with membrane stripping (40.2 vs. 39.4 weeks, p = 0.02, d = 0.62), though not clinically significant. Higher birth weight in the membrane stripping group (3663.0 g vs. 3394.8 g, p = 0.01, Cohen’s d = 0.63) was similarly not clinically significant. No effects were observed on birth type (p > 0.99), feeding type at 72 h or 6 weeks (p = 0.82, p > 0.99), transfer after 32 weeks (p = 0.36), or maternal and neonatal clinical notes (p = 0.29, p > 0.99). Potential confounders like gravida, para, abortus status (p = 0.79, p = 0.20, p = 0.26), prior cesarean section (p = 0.99), and maternal age (p = 0.69) did not affect outcomes.

Conclusions

Membrane stripping was not associated with adverse maternal or neonatal surrogate outcomes in Group B Streptococcus-positive pregnancies. These findings support its potential safety, though larger multi-center studies are needed to inform clinical guidelines.