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Journal of Perinatal Medicine

Official Journal of the World Association of Perinatal Medicine

Editor-in-Chief: Dudenhausen, Joachim W.

Editorial Board Member: / Bancalari, Eduardo / Greenough, Anne / Genc, Mehmet R. / Chervenak, Frank A. / Chappelle, Joseph / Bergmann, Renate L. / Bernardes, J.F. / Bevilacqua, G. / Blickstein, Isaac / Cabero Roura, Luis / Carbonell-Estrany, Xavier / Carrera, Jose M. / D`Addario, Vincenzo / D'Alton, MD, Mary E. / Dimitrou, G. / Grunebaum, Amos / Hentschel, Roland / Köpcke, W. / Kawabata, Ichiro / Keirse, M.J.M.C. / Kurjak M.D., Asim / Lee, Ben H. / Levene, Malcolm / Lockwood, Charles J. / Marsal, Karel / Makatsariya, Alexander / Nishida, Hiroshi / Papp, Zoltán / Pejaver, Ranjan Kumar / Pooh, Ritsuko K. / Romero, Roberto / Saugstad, Ola D. / Schenker, Joseph G. / Sen, Cihat / Seri, Istvan / Vetter, Klaus / Winn, Hung N. / Young, Bruce K. / Zimmermann, Roland

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Efficacy of a strategy to prevent neonatal early-onset group B streptococcal (GBS) sepsis

Regina M. Renner1 / A. Renner2 / Seraina Schmid3 / Irene Hoesli4 / Per Nars5 / Wolfgang Holzgreve6 / Daniel V. Surbek7

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Corresponding author: Dr. Daniel V. Surbek Department of Obstetrics and Gynecology University Hospital Berne Effingerstrasse 102 3010 Berne/Switzerland

Citation Information: Journal of Perinatal Medicine. Volume 34, Issue 1, Pages 32–38, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/JPM.2006.005, January 2006

Publication History

Received:
July 8, 2005
Revised:
August 29, 2005
Accepted:
October 10, 2005
Published Online:
2006-01-11

Abstract

Background: Existing guidelines recommend different strategies to prevent early-onset neonatal GBS sepsis. In 1997, using our own data on incidence and risk factors, we established a new prevention strategy which includes GBS screening at 36 weeks' gestation and intrapartum antibiotic prophylaxis (IAP) in women with positive or unknown GBS colonization with at least one risk factor. The present study evaluates the efficacy of the new prevention strategy.

Methods: Retrospective study of the incidence of early-onset GBS sepsis among all live births at the University Women's Hospital Basel between 1997 and 2002. Additional analysis of delivery and post partum period of all GBS sepsis cases, including GBS screening, risk factors during labor (prematurity, rupture of membranes (ROM) <12 h, intrapartum signs of infection), and IAP. Comparison of this group's characteristics G2 (9,385 live births, using the new strategy) with the previous group, G1 (1984–1993, 16,126 live births, without GBS screening or routine IAP) was performed.

Results: The incidence of early-onset GBS sepsis was reduced from 1/1000 (G1) to 0.53/1000 (G2). We observed a significant reduction of overall intrapartum riskfactors in cases of GBS sepsis.

Conclusion: This study suggests that our new prevention strategy is effective in reducing the incidence of early-onset GBS sepsis in neonates. In comparison, implementation of the CDC's prevention strategy might have prevented 2 additional cases in 9385 live births. However, this would have required treating a much larger number of pregnant women with IAP with consequential increasing costs, side effects and complications.

Keywords: Antibiotic prophylaxis; early onset sepsis; female; group B streptococcus; newborn; pregnancy complications; risk factors; streptococcal infections/pc [prevention & control]; streptococcus agalactiae; Switzerland

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[2]
J. Dahan-Saal, P. Gérardin, P.-Y. Robillard, G. Barau, A. Bouveret, S. Picot, A. Fianu, and M. Boukerrou
Gynécologie Obstétrique & Fertilité, 2011, Volume 39, Number 5, Page 281
[3]
MB Berger, X Xu, JA Williams, CJM Van de Ven, and EL Mozurkewich
BJOG: An International Journal of Obstetrics & Gynaecology, 2012, Volume 119, Number 4, Page 439
[4]
Dolly Sharma and Paul Spearman
Clinics in Perinatology, 2008, Volume 35, Number 2, Page 407
[5]
C. Thibaudon Baveux, A. Stroebel Noguer, I. Boulard Mallet, M. Djavadzadeh-Amini, N. Kacet, P. Truffert, D. Subtil, and J.-P. Dubos
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Alma-Verena Rausch, Ariane Gross, Sara Droz, Thomas Bodmer, and Daniel V. Surbek
Journal of Perinatal Medicine, 2009, Volume 37, Number 2
[7]
Po-Jen Cheng, Ho-Yen Chueh, Ching-Ming Liu, Jenn-Jeih Hsu, Tʼsang-Tʼang Hsieh, and Yung-Kuei Soong
Obstetrics & Gynecology, 2008, Volume 111, Number 3, Page 704

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