학술논문

An area-based study on intrapartum antibiotic prophylaxis for preventing group B streptococcus early-onset disease: advances and limitations.
Document Type
Journal Article
Source
Journal of Maternal-Fetal & Neonatal Medicine. Jul2017, Vol. 30 Issue 14, p1739-1744. 6p.
Subject
*STREPTOCOCCUS
*PREVENTIVE medicine
*FEMALES
*STREPTOCOCCACEAE
*STREPTOCOCCAL disease prevention
*ANTIBIOTICS
*PREMATURE infants
*MATERNAL health services
*MEDICAL protocols
*RECTUM
*STREPTOCOCCAL diseases
*VAGINA
*RETROSPECTIVE studies
*VERTICAL transmission (Communicable diseases)
*AMPICILLIN
*ANTIBIOTIC prophylaxis
*INFECTIOUS disease transmission
Language
ISSN
1476-7058
Abstract
Introduction: The prevalence of maternal group-B-streptococcus (GBS) colonization and risk factors (RFs) for neonatal early-onset disease (EOD) in Europe are poorly defined. Large-scale information concerning adherence to recommendations for preventing GBS-EOD are lacking.Materials and Methods: This was a 3-month retrospective area-based study including all regional deliveries  ≥35 weeks' gestation (in 2012). The sensitivity, specificity, positive and negative predictive values, odds ratio and receiver operating characteristic (ROC) curve for intrapartum antibiotic prophylaxis (IAP) among full-term and preterm deliveries and prolonged membrane rupture (PROM) were calculated.Results: Among 7133 women, 259 (3.6%) were preterm (35-36 weeks' gestation). Full-term women were 6874, and 876 (12.7%) had at least 1 RF. Most women (6495) had prenatal screening and 21.4% (1390) were GBS positive. IAP was given to 2369 (33.2%) women (preterm, n = 166; full term, n = 2203). Compared to full-term, preterm women were less likely to receive IAP when indicated (73.2% versus 90.3%, p < 0.01). Full-term women represented the largest area under the curve (AUC, 0.87). PROM showed the highest sensitivity (98.6%), but the lowest specificity (6.9%) and AUC (0.53).Conclusions: Large-scale prenatal screening and IAP are feasible. Women delivering preterm are less likely to receive IAP when indicated. Most unnecessary antibiotics are given in cases of PROM. [ABSTRACT FROM AUTHOR]