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J Trop Pediatr. 2018 Aug 1;64(4):312-316. doi: 10.1093/tropej/fmx068.

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

Author information

1
Neonatology Department, Christian Medical College, Vellore 632004, India.
2
Department of Biostatistics, Christian Medical College, Vellore 632004, India.
3
Department of Obstetrics, Christian Medical College, Vellore 632004, India.

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.

PMID:
29036682
DOI:
10.1093/tropej/fmx068

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