CHAMPS Data Highlights Hidden Burden of GBS-Associated Stillbirths

By Lisper Mokaya

Findings presented during the 4th International Symposium on Streptococcus agalactiae Disease (ISSAD 2026) has provided critical insights into the role of Group B Streptococcus (GBS) in stillbirths, revealing that the pathogen remains a significant yet under-recognized contributor to preventable fetal deaths globally.

Presenting on ‘GBS-Associated Stillbirths: Most Recent Data and Lessons Learned from CHAMPS,’ CHAMPS Director of Site Strategy and Implementation for the Child Health and Mortality Prevention and Surveillance, Dr. Victor Akelo shared findings from the Child Health and Mortality Prevention Surveillance Network (CHAMPS), a global surveillance platform designed to generate accurate cause-of-death data in regions where routine clinical records are often incomplete or unavailable.

Dr. Akelo explained that determining the true causes of stillbirth has historically been challenging, particularly in low- and middle-income countries where diagnostic CHAMPS Data Highlights Hidden Burden of GBS-Associated Stillbirths capacity is limited. The CHAMPS network addresses this challenge through a comprehensive methodology that combines verbal autopsy, microbiological testing across multiple tissue samples, and detailed histopathological examination. According to him, this integrated approach provides a far more reliable framework for attributing causality compared to conventional surveillance systems.

“CHAMPS offers a uniquely rigorous approach to understanding why deaths occur, especially in settings where clinical documentation alone cannot provide answers.” Dr. Akelo noted.

Data generated through the network indicate that GBS accounts for approximately two percent of all stillbirths when measured using cause-specific mortality fractions. More notably, GBS emerged as the second most frequently identified pathogen among infectious stillbirths, contributing to nearly twenty percent of infection-related cases. These findings, Dr. Akelo emphasized, suggest that the burden of GBS-associated stillbirth has been substantially underestimated.

A major concern highlighted during the presentation was the inadequacy of commonly used diagnostic approaches. Findings showed that blood and lung polymerase chain reaction (PCR) testing demonstrated significantly higher sensitivity 45 percent and 48 percent respectively compared to blood culture alone, which detected only 17 percent of cases.

“Reliance on blood culture alone significantly limits our ability to detect GBS in stillbirth investigations.” He explained. “Using multiple tissue samples together with molecular diagnostics provides a clearer picture of disease causation.”

The presentation also exposed operational challenges that continue to hinder effective stillbirth surveillance. Collecting certain biological samples from stillborn infants remains difficult, with cerebrospinal fluid successfully obtained in only a small proportion of cases. Maternal swabs were available in just thirteen percent of investigations, while placental tissue considered essential for accurate diagnosis was collected in roughly half of the cases reviewed. In addition, gestational age was unknown in nearly one-third of stillbirths, complicating efforts to distinguish between preterm and term outcomes.

 Dr. Akelo stressed that these limitations go beyond logistical inconvenience and represent systemic barriers to building the evidence base required for prevention programmes.

“These gaps directly affect our ability to generate the data needed to justify and design effective interventions,” he said.

Drawing lessons from CHAMPS implementation, the presentation underscored the need for significant investment in pathology and laboratory capacity, particularly in low-resource settings. Adoption of multitissue PCR testing combined with histopathological analysis was recommended as the methodological standard for stillbirth investigations involving GBS and other infectious pathogens.

Strengthening maternal screening programmes and ensuring systematic linkage between maternal colonization data and newborn outcomes were also identified as critical steps toward improving surveillance and informing policy decisions. Dr. Akelo emphasized that the availability of preventive interventions including maternal vaccination and intrapartum antibiotic treatment makes the case for urgent policy action increasingly compelling.

“GBS-associated stillbirth is both preventable and treatable,” he concluded. “The evidence clearly supports scaling up surveillance and prevention efforts without delay.”

The findings presented reinforced broader discussions at ISSAD 2026 on the importance of strengthening diagnostic systems alongside advancing maternal immunisation strategies. By improving how stillbirths are investigated and understood, experts noted, health systems can move closer to preventing avoidable losses and ensuring healthier outcomes for mothers and newborns worldwide.