An area-based study on intrapartum antibiotic prophylaxis for preventing group B streptococcus early-onset disease: advances and limitations |
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| Authors: | Alberto Berardi Cecilia Rossi Maria Letizia Bacchi Reggiani Annalisa Bastelli Maria Grazia Capretti Claudio Chiossi |
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| Institution: | 1. Unità Operativa di Terapia Intensiva Neonatale, Dipartimento Integrato Materno-Infantile, Azienda Ospedaliero-Universitaria Policlinico, Modena, Italy,;2. Terapia Intensiva Neonatale, Dipartimento Ostetrico e Pediatrico, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy,;3. Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Azienda Ospedaliero Universitaria S. Orsola-Malpighi, Bologna, Italy,;4. Unità Operativa di Terapia Intensiva Neonatale, Dipartimento Materno Infantile, Ospedale Maggiore, Bologna, Italy,;5. Unità Operativa di Neonatologia, Dipartimento del bambino, della donna e delle malattie urologiche, Azienda Ospedaliero Universitaria S. Orsola-Malpighi, Bologna, Italy,;6. Unità Operativa di Pediatria, Ospedale Civile, Sassuolo, Italy, |
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| Abstract: | Introduction: The prevalence of maternal group-B-streptococcus (GBS) colonization and risk factors (RFs) for neonatal early-onset disease (EOD) in Europe are poorly defined. Large-scale information concerning adherence to recommendations for preventing GBS-EOD are lacking.Materials and methods: This was a 3-month retrospective area-based study including all regional deliveries ≥35 weeks' gestation (in 2012). The sensitivity, specificity, positive and negative predictive values, odds ratio and receiver operating characteristic (ROC) curve for intrapartum antibiotic prophylaxis (IAP) among full-term and preterm deliveries and prolonged membrane rupture (PROM) were calculated.Results: Among 7133 women, 259 (3.6%) were preterm (35–36 weeks' gestation). Full-term women were 6874, and 876 (12.7%) had at least 1?RF. Most women (6495) had prenatal screening and 21.4% (1390) were GBS positive.IAP was given to 2369 (33.2%) women (preterm, n?=?166; full term, n?=?2203). Compared to full-term, preterm women were less likely to receive IAP when indicated (73.2% versus 90.3%, p?Conclusions: Large-scale prenatal screening and IAP are feasible. Women delivering preterm are less likely to receive IAP when indicated. Most unnecessary antibiotics are given in cases of PROM. |
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| Keywords: | Group B streptococcus sepsis intrapartum antibiotic prophylaxis newborn risk factors prevention |
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