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Mother exposes newborn to group B streptococcus after taking placenta pills
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An infant in Oregon was hospitalized with a late-onset group B streptococcus infection that researchers linked to maternal consumption of capsules containing dehydrated placenta.
According to Genevieve L. Buser, MDCM, infectious disease physician at Providence Pediatric Infectious Disease in Portland, Oregon, and colleagues, DNA tests showed that two group B streptococcus (GBS) infections in the infant were indistinguishable from GBS isolated from placenta pills consumed by the mother in the days following the infant’s birth.
Buser and colleagues recommended that in cases of late-onset GBS, clinicians ask mothers about a history of ingesting placenta and educate them about the potential risks of consuming it.
Their report was published in MMWR.
“Placenta ingestion is a growing practice among certain postpartum women,” Buser told Infectious Disease News. She had a message for clinicians: “Ask and educate your patients. There are potential risks to ingesting placental tissue with bacterial contamination.”
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In addition, scientific evidence is lacking supporting the claims by some that ingesting placenta has physical and psychological benefits for postpartum women, Buser and colleagues said. The pills in this case contained dehydrated placenta.
“No standards exist for processing placenta for consumption,” Buser and colleagues wrote. “In this case, heating for sufficient time at a temperature adequate to decrease GBS bacterial counts might not have been reached.”
Infection followed initial treatment for early-onset GBS
According to the report, the Oregon Health Authority was notified of a case of late-onset GBS in an infant that began 5 days after the infant had completed treatment for a case of early-onset GBS that developed shortly after birth. After being taken to the ED with irritability, the infant was admitted to the hospital and diagnosed with GBS.
According to Buser and colleagues, the physician treating the infant was notified by a physician from the birth hospital that the mother had requested the release of the placenta at the time of delivery. They said the mother acknowledged that, starting 3 days after the infant’s birth, she had begun taking two placenta pills three times a day.
She had tested negative for GBS through vaginal and rectal screenings before the birth, but Buser told Infectious Disease News that placentas are rarely cultured after birth because they are assumed to be contaminated with bacteria. Because the infant also contracted early-onset GBS, the researchers hypothesized that the placenta had been contaminated intrapartum or during passage through the birth canal, Buser said.
According to the report, the mother arranged for an unnamed company to pick up the placenta from the hospital and encapsulate it for her consumption. The company, Buser and colleagues said, requires mothers to report infection with HIV/AIDS, hepatitis, herpes, chlamydia, syphilis and Lyme disease, but not intra- or postpartum infections. The company’s website explains that it cleans, slices and dehydrates placentas at 115°F to 160°F, then grinds them and fills capsules that are kept at room temperature.
“Steps to prepare the placenta likely did not eliminate GBS,” Buser said.
She said ingesting the pills may have increased the mother’s gastrointestinal, urogenital or skin colonization with GBS, leading to the colonization of the infant.
“Studies suggest that colonization precedes infection in the infant,” she said. “As this is only a case report, more research would need to be done, but we thought that the provider community should know and ask about this exposure.”
Infection can be deadly
In the United States, GBS bacteria are the leading cause of meningitis and sepsis in a newborn’s first week, according to the CDC. The agency lists possible symptoms of GBS infection as fever, difficulty feeding, irritability or lethargy, difficulty breathing and bluish skin.
GBS can cause long-term problems like deafness and disabilities, and leads to death in 4% to 6% of cases, according to the CDC.
“We speculate that ingestion of placental tissue carrying a high burden of GBS — or other pathogens like E. coli — might lead to high maternal colonization, and thus might increase the risk of transmission and colonization of the newborn, who might, in turn, develop invasive disease,” Buser said. “If [clinicians] have an infant with early-onset sepsis of any kind or a mother with chorioamnionitis or GBS colonization, and the mother was planning to ingest her placenta, the provider could strongly recommend not doing so, in order to protect the infant's health.” – by Gerard Gallagher
Reference:
Buser GL, et al. MMWR Morb Mortal Wkly Rep. 2017;doi:10.15585/mmwr.mm6625a4.
Disclosure: The researchers report no relevant financial disclosures.