Neonatal Group B Streptococcal Bacteremia Associated With Placentophagy
August 1, 2017 4 minutes read
By Philip R. Fischer, MD, DTM&H
Professor of Pediatrics, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
Dr. Fischer reports no financial relationships relevant to this field of study.
SYNOPSIS: Associated with a mother’s ingestion of encapsulated placenta, an otherwise healthy newborn developed and, with antimicrobial treatment, recovered from both early and late onset group B streptococcal bacteremia. This is apparently the first report of a serious negative consequence of maternal consumption of dried placenta.
SOURCE: Buser GL, Mató S, Zhang AY, et al. Notes from the Field: Late-onset infant group B streptococcus infection associated with maternal consumption of capsules containing dehydrated placenta — Oregon, 2016. MMWR Morb Mortal Wkly Rep 2017;66:677-678.
A child was born in Oregon following an uncomplicated term pregnancy. Vaginal and rectal screening for group B streptococcal colonization in the mother was negative at 37 weeks’ gestation. During the initial neonatal hospitalization, the child had respiratory distress, had group B streptococci recovered from a blood culture, and recovered with an 11-day course of parenteral ampicillin.
Five days after completion of the antibiotic treatment, the child was hospitalized for irritability. A blood culture again grew group B streptococci, and the child again recovered with antibiotic therapy. A breast milk culture was negative for group B streptococci, and no source of infection was identified on serial physical exams.
However, the treating physician team became aware that the mother had requested that a commercial company retrieve her placenta at the time of delivery. The placenta had been cleaned, sliced, dried, ground, and encapsulated. The mother received the capsules of dried placental tissue three days post-partum and started ingesting two capsules three times daily. (A placenta reportedly yields approximately 150 capsules of tissue.)
A sample of encapsulated placenta was cultured and yielded group B streptococci. All three streptococcal isolates (one from each episode of bacteremia and one from the encapsulated placenta) were indistinguishably similar by pulsed-field gel electrophoresis and whole genome sequencing. Sequencing predicted a strain that has virulence factors that facilitate adhesion to and invasion from the intestines of the infant into the bloodstream.
COMMENTARY
Presumably, the mother was colonized with group B streptococci between the 37th week of gestation (when she tested negative) and the time of delivery. The child then had early-onset bacteremia from organisms acquired during labor and delivery. During the child’s first treatment course, the mother was apparently ingesting and becoming colonized (perhaps all over her skin) with the same streptococcal germs that had colonized the placenta. After recovering from the first infection, the baby then was colonized with the same germ again, and the microorganisms gained access, presumably after the child’s ingestion of germs that contacted the child’s mouth, into the child’s bloodstream, from which they caused the second infection. With the mother’s cessation of use of the encapsulated placenta, the child recovered without further problems.
So, why was the mother ingesting encapsulated placenta?
Many animals eat placental tissue, but ingestion of placentas (placentophagy) had been rare in humans. Nonetheless, placentas were sometimes used in traditional Chinese medicine.1,2 The authors of an uncontrolled study in 1954 reported that women receiving nebulized placental tissue felt like they had improved milk production.3 A 1979 report mentioned a “member of the counter culture” who consumed a placenta following a delivery assisted by friends in a commune; the group ingested the placenta and found it “wonderfully replenishing and delicious.”4 The practice of placentophagy continued and then became more popular during the past decade. Without any scientific support, proponents of the practice claim that placentophagy improves maternal health, mood, and lactation.1
Anecdotal evidence suggests that the practice of consuming human placentas is growing in North America, Europe, and Australia.1 In Portland, OR, for instance, it is estimated that 2,000 women consumed their placentas between 2009 and 2014.1 Most consumers of placenta are white, have had at least some college education, and earn more than $50,000 per year; in the United States, the practice seems most common on the West Coast.1 Interestingly, one survey suggested that two-thirds of women who consume placentas had opted for home births.1
The development of an industry around the preparation of placental capsules (there are more than 100 certified encapsulators of placental tissue1) has taken place outside of the confines of the medical care system. Physicians should be aware of the practice. And, now with the recently reported case of a serious bacterial infection related to the use of placental capsules, new mothers should be aware that the ingestion of dried placenta is not free of risk.
REFERENCES
- Hayes EH. Consumption of the placenta in the postpartum period. J Obstet Gynecol Neonatal Nurs 2016;45:78-89.
- Marraccini ME, Gorman KS. Exploring placentophagy in humans: Problems and recommendations. J Midwifery Womens Health 2015;60:371-379.
- Soykova-Pachnerova E, Brutar V, Golova B, Zvolska E. Placenta as a lactagogon. Gynaecologia 1954;138:617-627.
- Ober WB. Notes on placentophagy. Bull N Y Acad Med 1979;55:591-599.
Associated with a mother’s ingestion of encapsulated placenta, an otherwise healthy newborn developed and, with antimicrobial treatment, recovered from both early and late onset group B streptococcal bacteremia. This is apparently the first report of a serious negative consequence of maternal consumption of dried placenta.
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