| Popis: |
Strategies to reduce early-onset sepsis (EOS) with group B streptococcus (GBS) have relied on the administration of maternal intra-partum antibiotics (IPA) to mothers with identified risk factors. We studied the relationship between IPA, risk factors, and EOS for 14 years in our hospital, an inner-city, tertiary center serving primarily poor, high-risk, African-American mothers. Methods For each birth from 1989 to 2002, we identified presence or absence of maternal risk factors (prolonged rupture of membranes [PROM], chorioamnionitis, prematurity [ Results Data from ∼44,000 pregnancies were collected. The most common risk factor was prematurity (21% of deliveries). The percentage of mothers with any identified risk factor did not change significantly over the study period (∼33% of deliveries). From 1989 to 2002, IPA rose from 13% to 44% of all deliveries (p Conclusions 1) IPA tripled between 1989 and 2002. 2) Yet EOS was unaffected—both GBS and non-GBS EOS persisted at ∼2/1000 live births. 3) We suggest that vaccination will eventually be needed to reduce GBS EOS in our institution. We have no good idea how to reduce non-GBS EOS cases. |
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