부산대학교 도서관

OBJECTIVES: To ascertain guideline adherence for prevention of Group B Streptococcal (GBS) neonatal infection and establish prevalence and outcomes in Northern Ireland (NI). DESIGN: Retrospective observational study. SETTING: Northern Ireland maternity units. POPULATION: Using NI Health Information Systems the following were identified: (1) a cohort of women with one or more risk factors for GBS disease in 2009–2010, (2) all culture-positive cases of GBS in babies aged 0–89 days (2008–2010), (3) stillbirths due to GBS (2009–2010). METHODS: Information was analysed for a 15% randomised sample of the available cases. Maternal and infant case notes were reviewed for confirmed cases of neonatal early onset GBS (EOGBS) during 2008–2010. MAIN OUTCOME MEASURES: Adherence to the 2003 RCOG guideline on prevention of GBS disease (2009–2010). Number of neonatal GBS infections: antenatal risk factors, management and neonatal outcomes (2008–2010). The number of stillbirths related to GBS (2009–2010). RESULTS: Five hundred and seventy-four women had one or more identifiable risk factors for GBS disease; intrapartum antibiotic prophylaxis (IAP) was administered in 42% of cases. Improved administration of IAP was noted in the presence of escalating risk factors. At best, guideline adherence was 50–70%. Forty-three neonates had proven early-onset Group B Streptococcal disease; 55.8% had maternal risk factors. Of the total identified cases, 25.5% received IAP. The total mortality rate was 11.46%. The incidence of EOGBS disease in NI was 0.57/1000 live births. CONCLUSIONS: Prevalence of EOGBS is higher in NI than the UK as a whole. Risk factors are present in 55.8% of mothers; IAP does not prevent all cases of EOGBS.