This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Benitz, W. E.
Right arrow Articles by Druzin, M. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Benitz, W. E.
Right arrow Articles by Druzin, M. L.
Related Collections
Right arrow Infectious Disease & Immunity

PEDIATRICS Vol. 103 No. 6 June 1999, p. e77

ELECTRONIC ARTICLE:
Risk Factors for Early-onset Group B Streptococcal Sepsis: Estimation of Odds Ratios by Critical Literature Review

Received Oct 1, 1997; accepted Jan 27, 1999.

William E. Benitz*, Jeffrey B. GouldDagger , and Maurice L. Druzin§

From the Departments of * Pediatrics and § Gynecology and Obstetrics, Stanford University, School of Medicine, Stanford, California 94305; and Dagger  Maternal and Child Health Program, School of Public Health, University of California, Berkeley, California.

Objective.  To identify and to establish the prevalence of ORs for factors associated with increased risk for early-onset group B streptococcal (EOGBS) infection in neonates.

Study Design.  Literature review and reanalysis of published data.

Results.  Risk factors for EOGBS infection include group B streptococcal (GBS)-positive vaginal culture at delivery (OR: 204), GBS-positive rectovaginal culture at 28 (OR: 9.64) or 36 weeks gestation (OR: 26.7), vaginal Strep B OIA test positive at delivery (OR: 15.4), birth weight <=  2500 g (OR: 7.37), gestation <37 weeks (OR: 4.83), gestation <28 weeks (OR: 21.7), prolonged rupture of membranes (PROM) >18 hours (OR: 7.28), intrapartum fever >37.5°C (OR: 4.05), intrapartum fever, PROM, or prematurity (OR: 9.74), intrapartum fever or PROM at term (OR: 11.5), chorioamnionitis (OR: 6.43). Chorioamnionitis is reported in most (88%) cases in which neonatal infection occurred despite intrapartum maternal antibiotic therapy. ORs could not be estimated for maternal GBS bacteriuria during pregnancy, with preterm premature rupture of membranes, or with a sibling or twin with invasive GBS disease, but these findings seem to be associated with a very high risk. Multiple gestation is not an independent risk factor for GBS infection.

Conclusions.  Mothers with GBS bacteriuria during pregnancy, with another child with GBS disease, or with chorioamnionitis should receive empirical intrapartum antibiotic treatment. Their infants should have complete diagnostic evaluations and receive empirical treatment until infection is excluded by observation and negative cultures because of their particularly high risk for EOGBS infection. Either screening with cultures at 28 weeks gestation or identification of clinical risk factors, ie, PROM, intrapartum fever, or prematurity, may identify parturients whose infants include 65% of those with EOGBS infection. Intrapartum screening using the Strep B OIA rapid test identifies more at-risk infants (75%) than any other method. These risk identifiers may permit judicious selection of patients for prophylactic interventions.  Key words:  group B streptococcus, neonatal sepsis, early-onset sepsis, risk factors, prevention.




This article has been cited by other articles:


Home page
 Obstet GynecolHome page
A. Herbst and K. Kallen
Time Between Membrane Rupture and Delivery and Septicemia in Term Neonates
Obstet. Gynecol., September 1, 2007; 110(3): 612 - 618.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
J. L. Illuzzi and M. B. Bracken
Duration of intrapartum prophylaxis for neonatal group B streptococcal disease: a systematic review.
Obstet. Gynecol., November 1, 2006; 108(5): 1254 - 1265.
[Abstract] [Full Text] [PDF]

Home page
 Obstet GynecolHome page
R. D. Stapleton, J. M. Kahn, L. E. Evans, C. W. Critchlow, and C. M. Gardella
Risk Factors for Group B Streptococcal Genitourinary Tract Colonization in Pregnant Women
Obstet. Gynecol., December 1, 2005; 106(6): 1246 - 1252.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
W Hofhuis, J C de Jongste, and P J F M Merkus
Adverse health effects of prenatal and postnatal tobacco smoke exposure on children
Arch. Dis. Child., December 1, 2003; 88(12): 1086 - 1090.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
A. Madan, M. M. Adams, and A. G. S. Philip
Frequency and Timing of Symptoms in Infants Screened for Sepsis: Effectiveness of a Sepsis-Screening Pathway
Clinical Pediatrics, January 1, 2003; 42(1): 11 - 18.
[Abstract] [PDF]

Home page
 BMJHome page
S. Oddie and N. D Embleton
Risk factors for early onset neonatal group B streptococcal sepsis: case-control study
BMJ, August 10, 2002; 325(7359): 308 - 308.
[Abstract] [Full Text] [PDF]