 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Robin Proctor, University of Pennsylvania, 133 E. Mermaid Lane, front, Philadelphia, PA 19188, N/A, rproctor@nursing.upenn.edu, Pam Daily, California Emerging Infections Program, 1212 Broadway, 12th Floor, Oakland, CA 94612, and Janet Mohle-Boetani, MD, Division of Communicable Disease Control, California Department of Health Services, 2151 Berkeley Way, Berkeley, CA 94704.
Background: In the United States, Group B streptococcus (GBS) is the most common cause of neonatal sepsis in the first week of life (early-onset). From 1996 to 2002 there were two recommended strategies to prevent early-onset GBS (EOGBS) disease in neonates. We conducted a study to determine which protocol was more effective. Study Design: We abstracted information from 494 maternal labor and delivery charts selected through random, stratified sampling of all 78,264 live births that occurred between January 1, 1998 and December 31, 1999 in the California site of the Active Bacterial Core surveillance (ABCs) project. We reviewed maternal charts of all 24 cases of EOGBS disease identified by population-based active surveillance in the same site. Women with documentation of prenatal GBS screening were considered exposed to the screening-based approach; women without documentation of GBS screening were considered exposed to the risk-based approach. Results: Five (20.8%) mothers of cases versus 231 (46.8%) mothers of controls were screened for GBS during pregnancy (p=0.019, Fisher's exact test). In adjusted analyses, the screening-based approach was protective relative to the risk-based approach when controlling for the effects of non-Hispanic African American race, intrapartum fever °Ý 38.0°ãC, maternal age < 25 years, and pre-term delivery (adjusted OR = 0.32; 95% CI: 0.11-0.93). Conclusions: EOGBS disease is best prevented by selecting candidates for intrapartum antibiotics using the screening-based approach as opposed to the risk-based approach. Universal implementation of this protocol could halt the recent increase in EOGBS disease.
Learning Objectives:
Keywords: Prenatal Care, Survey
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.