1. An area-based study on intrapartum antibiotic prophylaxis for preventing group B streptococcus early-onset disease: advances and limitations.
- Author
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Berardi A, Rossi C, Bacchi Reggiani ML, Bastelli A, Capretti MG, Chiossi C, Fiorini V, Gambini L, Gavioli S, Lanari M, Memo L, Papa I, Pini L, Rizzo MV, Zucchini A, Facchinetti F, and Ferrari F
- Subjects
- Female, Guideline Adherence, Humans, Infectious Disease Transmission, Vertical, Pregnancy, Premature Birth, Rectum microbiology, Retrospective Studies, Risk Factors, Streptococcal Infections congenital, Streptococcal Infections transmission, Vagina microbiology, Ampicillin administration & dosage, Anti-Bacterial Agents administration & dosage, Antibiotic Prophylaxis statistics & numerical data, Perinatal Care statistics & numerical data, Streptococcal Infections prevention & control
- Abstract
Introduction: The prevalence of maternal group-B-streptococcus (GBS) colonization and risk factors (RFs) for neonatal early-onset disease (EOD) in Europe are poorly defined. Large-scale information concerning adherence to recommendations for preventing GBS-EOD are lacking., Materials and Methods: This was a 3-month retrospective area-based study including all regional deliveries ≥35 weeks' gestation (in 2012). The sensitivity, specificity, positive and negative predictive values, odds ratio and receiver operating characteristic (ROC) curve for intrapartum antibiotic prophylaxis (IAP) among full-term and preterm deliveries and prolonged membrane rupture (PROM) were calculated., Results: Among 7133 women, 259 (3.6%) were preterm (35-36 weeks' gestation). Full-term women were 6874, and 876 (12.7%) had at least 1 RF. Most women (6495) had prenatal screening and 21.4% (1390) were GBS positive. IAP was given to 2369 (33.2%) women (preterm, n = 166; full term, n = 2203). Compared to full-term, preterm women were less likely to receive IAP when indicated (73.2% versus 90.3%, p < 0.01). Full-term women represented the largest area under the curve (AUC, 0.87). PROM showed the highest sensitivity (98.6%), but the lowest specificity (6.9%) and AUC (0.53)., Conclusions: Large-scale prenatal screening and IAP are feasible. Women delivering preterm are less likely to receive IAP when indicated. Most unnecessary antibiotics are given in cases of PROM.
- Published
- 2017
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