Perinatal Risk Factors for Neonatal Early-onset Group B Streptococcal Sepsis after Initiation of Risk-based Maternal Intrapartum Antibiotic Prophylaxis—A Case Control Study

Abstract Objectives To identify the perinatal risk factors for early-onset Group B Streptococcus (EOGBS) sepsis in neonates after inception of a risk-based maternal intrapartum antibiotic prophylaxis strategy in 2004. Design Case control study. Methods All newborn with early onset GBS sepsis (born b...

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Published in:Journal of tropical pediatrics (1980) 2018-08, Vol.64 (4), p.312-316
Main Authors: Santhanam, Sridhar, Arun, Sumita, Rebekah, Grace, Ponmudi, Nithya J, Chandran, Jolly, Jose, Ruby, Jana, Atanu Kumar
Format: Article
Language:English
Subjects:
Anti-Bacterial Agents - administration & dosage
Anti-Bacterial Agents - therapeutic use
Antibiotic Prophylaxis
Case-Control Studies
Female
Humans
Incidence
India - epidemiology
Infant, Newborn
Infectious Disease Transmission, Vertical - prevention & control
Neonatal Sepsis - diagnosis
Pregnancy
Pregnancy Complications, Infectious - drug therapy
Pregnancy Complications, Infectious - epidemiology
Pregnancy Complications, Infectious - microbiology
Risk Factors
Streptococcal Infections - diagnosis
Streptococcal Infections - drug therapy
Streptococcal Infections - epidemiology
Streptococcal Infections - prevention & control
Streptococcus agalactiae - isolation & purification
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Summary:Abstract Objectives To identify the perinatal risk factors for early-onset Group B Streptococcus (EOGBS) sepsis in neonates after inception of a risk-based maternal intrapartum antibiotic prophylaxis strategy in 2004. Design Case control study. Methods All newborn with early onset GBS sepsis (born between 2004 and 2013) were deemed to be “cases” and controls were selected in a 1:4 ratio. Results More than three per vaginal (PV) examinations [odds ratio (OR) 8.57, 95% confidence interval (CI) 3.10–23.6] was a significant risk factors. Peripartum fever (OR 3.54, 95% CI 1.3–9.67), urinary tract infection (OR 2.88, 95% CI 1.08–7.63), meconium-stained amniotic fluid (MSAF) (OR 2.52, 95% CI 1.18–5.37) and caesarean section (OR 1.99, 95% CI 1.16–3.43) were also found to be associated with EOGBS sepsis. Conclusion Multiple vaginal examinations are the strongest risk factors for peripartum Group B Streptococcal (GBS) sepsis. The association of MSAF and caesarean section indicates that foetal distress is an early symptom of perinatal GBS infection.
ISSN:0142-6338
1465-3664
DOI:10.1093/tropej/fmx068