Purpose: Intrapartum antibiotic prophylaxis (IAP) prevents group B streptococcus (GBS) early-onset 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 (OR = 6.99), positive prenatal screening (OR = 13.7) and maternal intrapartum fever (OR = 188.3) were associated with an increased risk of EOD, whereas intrapartum beta-lactam antibiotics were associated with a decreased risk of EOD (≥4 h: OR = 0.008; <4 h: OR = 0.04). 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 / Berardi, Alberto; Spada, Caterina; Creti, Roberta; Ambretti, Simone; Chiarabini, Rossana; Barozzi, Agostino; Pagano, Rossella; Sarti, Mario; Pedna, Maria Federica; Fornaciari, Sara; Azzalli, Milena; Dodi, Icilio; Bacchi Reggiani, Maria Letizia; Lanzoni, Angela; Vaccina, Eleonora; Iughetti, Lorenzo; Lucaccioni, Laura. - In: THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE. - ISSN 1476-7058. - 33:14(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

Berardi, Alberto;Spada, Caterina;Pagano, Rossella;Fornaciari, Sara;Vaccina, Eleonora;Iughetti, Lorenzo;Lucaccioni, Laura
2020-01-01

Abstract

Purpose: Intrapartum antibiotic prophylaxis (IAP) prevents group B streptococcus (GBS) early-onset 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 (OR = 6.99), positive prenatal screening (OR = 13.7) and maternal intrapartum fever (OR = 188.3) were associated with an increased risk of EOD, whereas intrapartum beta-lactam antibiotics were associated with a decreased risk of EOD (≥4 h: OR = 0.008; <4 h: OR = 0.04). 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.
17-lug-2019
33
14
2480
2486
Risk factors for group B streptococcus early-onset disease: an Italian, area-based, case-control study / Berardi, Alberto; Spada, Caterina; Creti, Roberta; Ambretti, Simone; Chiarabini, Rossana; Barozzi, Agostino; Pagano, Rossella; Sarti, Mario; Pedna, Maria Federica; Fornaciari, Sara; Azzalli, Milena; Dodi, Icilio; Bacchi Reggiani, Maria Letizia; Lanzoni, Angela; Vaccina, Eleonora; Iughetti, Lorenzo; Lucaccioni, Laura. - In: THE JOURNAL OF MATERNAL-FETAL & NEONATAL MEDICINE. - ISSN 1476-7058. - 33:14(2020), pp. 2480-2486. [10.1080/14767058.2019.1628943]
Berardi, Alberto; Spada, Caterina; Creti, Roberta; Ambretti, Simone; Chiarabini, Rossana; Barozzi, Agostino; Pagano, Rossella; Sarti, Mario; Pedna, Maria Federica; Fornaciari, Sara; Azzalli, Milena; Dodi, Icilio; Bacchi Reggiani, Maria Letizia; Lanzoni, Angela; Vaccina, Eleonora; Iughetti, Lorenzo; Lucaccioni, Laura
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1179370
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