Unnecessary Workup of Asymptomatic Neonates in the Era of Group B Streptococcus Prophylaxis

Asymptomatic term neonates born to mothers who are Group B Streptococcus (GBS) unknown or GBS positive but “inadequately” treated prior to delivery do not require invasive laboratory evaluation. We conducted a retrospective cohort study of mother/baby dyads born from January 1, 2005 until September...

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Bibliographic Details
Published in:Infectious Diseases in Obstetrics and Gynecology 2010, Vol.2010 (2010), p.55-57
Main Authors: Buckler, Brad, Bell, Jason, Sams, Ralph, Cagle, William, Bell, Sue Anne, Allen, Carla, Sutherland, Don, Bhatia, Jatinder
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - therapeutic use
Antibiotics
Babies
Bacteremia - diagnosis
Blood
Blood Cell Count
C-Reactive Protein - analysis
Care and treatment
Cohort Studies
Diagnosis
Female
Health aspects
Humans
Infant, Newborn
Infants (Newborn)
Medical examination
Mothers
Pregnancy
Pregnancy Complications, Infectious - prevention & control
Retrospective Studies
Risk factors
Sepsis
Sepsis - microbiology
Sepsis - prevention & control
Streptococcal Infections - diagnosis
Streptococcal Infections - prevention & control
Streptococcus
Streptococcus agalactiae
Streptococcus agalactiae - isolation & purification
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Summary:Asymptomatic term neonates born to mothers who are Group B Streptococcus (GBS) unknown or GBS positive but “inadequately” treated prior to delivery do not require invasive laboratory evaluation. We conducted a retrospective cohort study of mother/baby dyads born from January 1, 2005 until September 30, 2007 at the Medical College of Georgia. Their current protocol is to obtain a Complete Blood Count with Differential (CBC with D), Blood Culture (BC), and C-reactive protein (CRP) after birth. Mother/baby dyads (n=242) that met inclusion criteria were reviewed. Of these 242 babies 25 (10%) were started on antibiotics after the initial lab values were known. None of the blood cultures were positive and the CRP's were normal. The 2002 GBS guidelines call for laboratory evaluation of “at-risk” neonates, but the workup of these babies is not only costly, it does not provide any advantage over old fashioned clinical observation for the evaluation and treatment of early onset GBS sepsis.
ISSN:1064-7449
1098-0997
DOI:10.1155/2010/369654