The objective of this paper is to evaluate the effect of different Prevention strategies on the rate of early-onset neonatal group B streptococcus (GBS) disease and mortality. We compared the neonatal mortality and morbidity rates associated with early-onset GBS disease in three periods characterized by different prevention strategies, including no screening for GBS during pregnancy and no standardized chemoprophylaxis (1/1987 to 12/1990), antibiotic prophylaxis only with risk factors for GBS (1/1991 to 12/1994), and universal screening for GBS with rectovaginal cultures and chemoprophylaxis for women with positive results or risk factors (1/1995 to 12/1999). Statistical analysis included Fisher's exact test and Chi-square, with a two-tailed p <0.05 considered significant. The yearly prevalence of positive GBS cultures was similar throughout the screening period (mean 18%, range 16 to 19%). Compared with the no prophylaxis group (rate = 4/8,573), introduction of universal screening (rate 0/13,754,p = 0.02) but not of prophylaxis for risk factors alone (rate = 1/10,303, = 0.18) significantly decreased the occurrence of GBS-specific neonatal mortality. Universal screening decreased, though not significantly, the GBS-specific neonatal morbidity rates compared with a policy based on risk factors alone (0.4/1000 vs. 0.8/1000,p = 0.29). Our study had a power to detect a 0.7/1000 difference in the rate of specific morbidity between the two chemoprophylaxis policies (alpha = 0.05, P= 0.80). Intrapartum prophylaxis for GBS, using universal screening or risk factors, is associated with a significant reduction in the specific neonatal mortality rate compared with no prophylaxis. Universal screening for GBS leads to a decrease in specific GBS morbidity compared with screening using risk factors alone

Vergani, P., Patane, L., Colombo, C., Borroni, C., Giltri, G., Ghidini, A. (2002). Impact of different prevention strategies on neonatal group B streptococcal disease. AMERICAN JOURNAL OF PERINATOLOGY, 19(6), 341-348 [10.1055/s-2002-34464].

Impact of different prevention strategies on neonatal group B streptococcal disease

Vergani, P;
2002

Abstract

The objective of this paper is to evaluate the effect of different Prevention strategies on the rate of early-onset neonatal group B streptococcus (GBS) disease and mortality. We compared the neonatal mortality and morbidity rates associated with early-onset GBS disease in three periods characterized by different prevention strategies, including no screening for GBS during pregnancy and no standardized chemoprophylaxis (1/1987 to 12/1990), antibiotic prophylaxis only with risk factors for GBS (1/1991 to 12/1994), and universal screening for GBS with rectovaginal cultures and chemoprophylaxis for women with positive results or risk factors (1/1995 to 12/1999). Statistical analysis included Fisher's exact test and Chi-square, with a two-tailed p <0.05 considered significant. The yearly prevalence of positive GBS cultures was similar throughout the screening period (mean 18%, range 16 to 19%). Compared with the no prophylaxis group (rate = 4/8,573), introduction of universal screening (rate 0/13,754,p = 0.02) but not of prophylaxis for risk factors alone (rate = 1/10,303, = 0.18) significantly decreased the occurrence of GBS-specific neonatal mortality. Universal screening decreased, though not significantly, the GBS-specific neonatal morbidity rates compared with a policy based on risk factors alone (0.4/1000 vs. 0.8/1000,p = 0.29). Our study had a power to detect a 0.7/1000 difference in the rate of specific morbidity between the two chemoprophylaxis policies (alpha = 0.05, P= 0.80). Intrapartum prophylaxis for GBS, using universal screening or risk factors, is associated with a significant reduction in the specific neonatal mortality rate compared with no prophylaxis. Universal screening for GBS leads to a decrease in specific GBS morbidity compared with screening using risk factors alone
Articolo in rivista - Articolo scientifico
group B streptococcus; neonatal sepsis; antibiotic prophylaxis; screening; risk-based approach
English
2002
19
6
341
348
none
Vergani, P., Patane, L., Colombo, C., Borroni, C., Giltri, G., Ghidini, A. (2002). Impact of different prevention strategies on neonatal group B streptococcal disease. AMERICAN JOURNAL OF PERINATOLOGY, 19(6), 341-348 [10.1055/s-2002-34464].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/17029
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