Details

Autor(en) / Beteiligte

• Lin, Feng Ying C.
• Brenner, Ruth A.
• Johnson, Yvette R.
• Azimi, Parvin H.
• Philips, Joseph B.
• Regan, Joan A.
• Clark, Penny
• Weisman, Leonard E.
• Rhoads, George G.
• Kong, Fanhui
• Clemens, John D.

Titel

The effectiveness of risk-based intrapartum chemoprophylaxis for the prevention of early-onset neonatal group B streptococcal disease

Ist Teil von

• American journal of obstetrics and gynecology, 2001-05, Vol.184 (6), p.1204-1210

Ort / Verlag

Philadelphia, PA: Elsevier Inc

Erscheinungsjahr

2001

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Objective: Our purpose was to evaluate the effectiveness of a risk-based intrapartum antibiotic prophylaxis strategy for the prevention of early-onset neonatal group B streptococcal disease. Study Design: Cases and controls were selected from infants born to women with one or more risk factors: preterm labor or rupture of membranes, prolonged rupture of membranes (>18 hours), fever during labor, or previous child with group B streptococcal disease. Cases were matched with controls by birth hospital and gestational age. Data abstracted from medical records were analyzed to estimate the effectiveness of intrapartum antibiotic prophylaxis. Results: We analyzed data from 109 cases and 207 controls. Nineteen (17%) case versus 69 (33%) control mothers received an acceptable regimen of intrapartum antibiotic prophylaxis. In adjusted analyses, the effectiveness of intrapartum antibiotic prophylaxis was 86% (95% confidence interval, 66%-94%). When the first dose of antibiotics was given ≥2 hours before delivery, the effectiveness increased to 89% (95% confidence interval, 70%-96%); when it was given within 2 hours of delivery, the effectiveness was 71% (95% confidence interval, –8%-92%). Effectiveness was lowest in mothers with intrapartum fever (72%, 95% confidence interval, –9%-93%). On the basis of a 70% prevalence of maternal risk factors expected among cases in the absence of intrapartum antibiotic prophylaxis, we estimate that the risk-based strategy could reduce early-onset group B streptococcal disease by 60%. Conclusions: The risk-based approach to intrapartum antibiotic prophylaxis is effective in preventing early-onset group B streptococcal disease. To achieve the maximum preventive effect, the first dose of antibiotics should be administered at least 2 hours before delivery. (Am J Obstet Gynecol 2001;184:1204-10.)