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Prevention of group B streptococcus vertical infection - a perinatal care unit experience.

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Author(s): Ana Aguiar

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830


ABSTRACT
Overview: Ever since group B Streptococcus (GBS) emerged as the commonest cause of perinatal sepsis, there has been controversy about prevention strategies.Objective: To acess the effectiveness of a protocol for prevention of vertical transmission of neonatal GBS infection in a perinatal care unit.Study design, population and methods: retrospective cohort of pregnant women and their neonates, admitted to a perinatal care hospital between January 2003 and December 2006. The Center for Disease Control and Prevention (CDC) guidelines were applied: screening of all pregnant women at 35-37 weeks of gestation; intravenous antibiotics for colonized women; screening of neonates from colonized women who had not completed prophylaxis. The results were analysed for accomplishment and effectiveness of the protocol. Results: Since the institution of the protocol, the screening rate of pregnant women rose, while the colonization rate remained stable between 8.2% and 12.8%. About two-thirds of carrier women received complete prophylaxis. Failure of prophylaxis and of neonatal screening tended to decrease over time, as did the incidence of early neonatal group B Streptococcus sepsis, and sepsis without an identified aetiological agent, but differences did not reach statistical significance. Conclusion: In spite of the increasing implementation of the guidelines, a statistically significant reduction in the incidence of early neonatal sepsis was not demonstrable.
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