Purpose: Intrapartum antibiotic prophylaxis (IAP) prevents group B streptococcus (GBS) earlyonset disease (EOD). No European study evaluates the relative impact of risk factors (RFs) for EOD after a screening-based strategy and widespread IAP use We aimed to evaluate the risks of EOD in an Italian region where a screening-based strategy for preventing EOD was implemented. Materials and methods: Cases of EOD born at or above 35 weeks’ gestation were reviewed and matched with controls. Results: There were 109 cases of EOD among 532,154 live births. Most cases had negative GBS prenatal screening (56/91, 61.5%) and were unexposed to IAP (86/109, 78.9%). At multivariate analysis, GBS bacteriuria (OR¼6.99), positive prenatal screening (OR¼13.7) and maternal intrapartum fever (OR¼188.3) were associated with an increased risk of EOD, whereas intrapartum beta-lactam antibiotics were associated with a decreased risk of EOD ( 4h: OR¼0.008; <4h: OR¼0.04). Neonates born to nonfebrile, GBS positive pregnant women, receiving beta-lactam antibiotics had very low probability of EOD, particularly if IAP was adequate. Conclusions: GBS positive prenatal screening, GBS bacteriuria and intrapartum fever are associated with EOD. Intrapartum beta-lactam antibiotics reduce the probability of EOD in neonates born to nonfebrile mothers.
Risk factors for group B streptococcus early-onset disease: an Italian, area-based, case-control study / Alberto, Berardi; Caterina, Spada; Roberta, Creti; Simone, Ambretti; Rossana Chiarabini, ; Agostino, Barozzi; Rossella, Pagano; Mario, Sarti; Maria, Federica Pedna; Sara, Fornaciari; Milena, Azzalli; Icilio, Dodi; Maria Letizia, Bacchi Reggiani; Angela, Lanzoni; Eleonora, Vaccina; Lorenzo Iughetti, & Laura Lucaccioni on behalf of the GBS Prevention Working Group of Emilia- Romagna; Biasucci, G. - In: THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE. - ISSN 1476-7058. - 33:(2020), pp. 2480-2486. [10.1080/14767058.2019.1628943]
Risk factors for group B streptococcus early-onset disease: an Italian, area-based, case-control study
Biasucci G
2020-01-01
Abstract
Purpose: Intrapartum antibiotic prophylaxis (IAP) prevents group B streptococcus (GBS) earlyonset disease (EOD). No European study evaluates the relative impact of risk factors (RFs) for EOD after a screening-based strategy and widespread IAP use We aimed to evaluate the risks of EOD in an Italian region where a screening-based strategy for preventing EOD was implemented. Materials and methods: Cases of EOD born at or above 35 weeks’ gestation were reviewed and matched with controls. Results: There were 109 cases of EOD among 532,154 live births. Most cases had negative GBS prenatal screening (56/91, 61.5%) and were unexposed to IAP (86/109, 78.9%). At multivariate analysis, GBS bacteriuria (OR¼6.99), positive prenatal screening (OR¼13.7) and maternal intrapartum fever (OR¼188.3) were associated with an increased risk of EOD, whereas intrapartum beta-lactam antibiotics were associated with a decreased risk of EOD ( 4h: OR¼0.008; <4h: OR¼0.04). Neonates born to nonfebrile, GBS positive pregnant women, receiving beta-lactam antibiotics had very low probability of EOD, particularly if IAP was adequate. Conclusions: GBS positive prenatal screening, GBS bacteriuria and intrapartum fever are associated with EOD. Intrapartum beta-lactam antibiotics reduce the probability of EOD in neonates born to nonfebrile mothers.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
