Intrapartum factors in early-onset group B streptococcal sepsis in term neonates: A case-control study

Abstract

OBJECTIVE: A case-control study was used to (1) examine the intrapartum characteristics of term neonates with early-onset group B streptococcal sepsis and (2) determine what percentage of patients meet The American College of Obstetricians and Gynecologists guideline for intrapartum administration of antibiotics. STUDY DESIGN: Twenty-one women delivered of term neonates who contracted early-onset group B streptococcal sepsis were matched with 63 mothers who were colonized with group B streptococci. The women were matched for race, age, parity, and gestational age. A Student t test and χ 2 analysis were performed. Significance was defined as p < 005. RESULTS: The attack rate was 2.1 instances of sepsis per 1000 live births. For both groups, the maternal demographics and the actual birth weights were similar. Case mothers compared with controls had longer labor (11.4 ± 6.9 vs 5.8 ± 4.3 hours, p < 0.0001), had longer time elapsed between rupture of membranes and delivery (10.3 ± 6.4 vs 3.2 ± 3.6 hours, p < 0.0001); required oxytocin more often (76% vs 32%, p < 0.001); required more pelvic examinations (6 or more; 71% vs 46%, p < 005); and had a significantly higher cesarean section rate (33% vs 3%; p < 0.001). Only 10% (2 of 21) of case mothers met The American College of Obstetricians and Gynecologists guideline for chemoprophylaxis. CONCLUSION: The American College of Obstetricians and Gynecologists guideline for chemoprophylaxis identifies only 10% of women whose term newborns contract early-onset group B streptococcal sepsis. (Am J Obstet Gynecol 1996;174:1934-40.)