Intrapartum prophylaxis against Group B Streptococcus infection - own experience

Introduction: Group B Streptococcus (GBS) infection is a leading cause of neonatal complications. Objectives: The aim of the following work was to assess the efficacy of the intrapartum antibiotic prophylaxis (IAP) of the GBS infection, together with the diagnostic and therapeutic management of the newborn, based on the type and frequency of neonatal complications in the children of GBS carriers. Material and methods: 2212 patients, who gave birth at the 1st Department of Obstetrics and Gynecology Medical University of Warsaw, between January 2007 and March 2008, were included in the study In accordance with current recommendations, all patients were screened for GBS colonization and carriers were qualified for IAP. In the end, the study group consisted of 250 GBS-positive parturients and their children (253). Retrospective analysis of the chosen variables and statistical analysis were performed. Results: GBS colonization rate in the studied population reached 11.4%. 199 parturients were qualified for IAP (79.56% of 250 women). Optimal chemoprophylaxis was administered in 87.9% of GBS carriers. Intrauterine infection was diagnosed in 13.04% of 253 newborns. In 2 cases (0.8%) GBS was the etiological factor of the infection. The neonatal infection rate was significantly lower among children of GBS-positive mothers who received IAP in comparison to those not qualified for prophylaxis (11.05% vs. 21.56%; p=0.036). The rate of intrauterine infection was also lower among newborns of mothers who had received prophylaxis with ampicillin in comparison to macrolides administration (8.2% vs. 37.5%; p=0.001). Conclusions: Optimal intrapartum antibiotic prophylaxis of GBS infection in carriers does not eliminate GBS-related neonatal complications. Intrapartum penicillin administration seems to be more efficient than macrolides administration in GBS infection prophylaxis.