Duration of intrapartum antibiotics for group B streptococcus on the diagnosis of clinical neonatal sepsis

Infect Dis Obstet Gynecol. 2013;2013:525878. doi: 10.1155/2013/525878. Epub 2013 Mar 28.

Abstract

Background: Infants born to mothers who are colonized with group B streptococcus (GBS) but received <4 hours of intrapartum antibiotic prophylaxis (IAP) are at-risk for presenting later with sepsis. We assessed if <4 hours of maternal IAP for GBS are associated with an increased incidence of clinical neonatal sepsis.

Materials and methods: A retrospective cohort study of women-infant dyads undergoing IAP for GBS at ≥37-week gestation who presented in labor from January 1, 2003 through December 31, 2007 was performed. Infants diagnosed with clinical sepsis by the duration of maternal IAP received (< or ≥4-hours duration) were determined.

Results: More infants whose mothers received <4 hours of IAP were diagnosed with clinical sepsis, 13 of 1,149 (1.1%) versus 15 of 3,633 (0.4%), P = .03. Multivariate logistic regression analysis showed that treatment with ≥4 hours of IAP reduced the risk of infants being diagnosed with clinical sepsis by 65%, adjusted relative risk 0.35, CI 0.16-0.79, and P = .01.

Conclusion: The rate of neonatal clinical sepsis is increased in newborns of GBS colonized mothers who receive <4 hours compared to ≥4 hours of IAP.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Antibiotic Prophylaxis / methods*
  • Carrier State / drug therapy
  • Female
  • Humans
  • Incidence
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Male
  • Multivariate Analysis
  • Pregnancy
  • Retrospective Studies
  • Sepsis / epidemiology
  • Sepsis / microbiology
  • Sepsis / prevention & control*
  • Streptococcal Infections / epidemiology
  • Streptococcal Infections / prevention & control
  • Streptococcal Infections / transmission*
  • Streptococcus agalactiae*
  • Texas / epidemiology
  • Time Factors

Substances

  • Anti-Bacterial Agents