INTRAPARTUM FACTORS IN EARLY-ONSET GROUP-B STREPTOCOCCAL SEPSIS IN TERM NEONATES - A CASE-CONTROL STUDY

OBJECTIVE: A case-control study was used to (1) examine the intrapartu m characteristics of term neonates with early-onset group B streptococ cal sepsis and (2) determine what percentage of patients meet The Amer ican College of Obstetricians and Gynecologists guideline for intrapar tum administration of antibiotics. STUDY DESIGN: Twenty-one women deli vered of term neonates who contracted early-onset group B streptococca l sepsis were matched with 63 mothers who were colonized with group B streptococci. The women were matched for race, age, parity, and gestat ional age. A Student t test and x(2) analysis were performed. Signific ance was defined as p < 0.05. RESULTS: The attack rate was 2.1 instanc es of sepsis per 1000 live births. For both groups, the maternal demog raphics and the actual birth weights were similar. Case mothers compar ed with controls had longer labor (11.4 +/- 6.9 vs 5.8 +/- 4.3 hours, p < 0.0001), had longer time elapsed between rupture of membranes and delivery (10.3 +/- 6.4 vs 3.2 +/- 3.6 hours, p < 0.0001); required oxy tocin more often (76% vs32%, p < 0.001); required more pelvic examinat ions (6 or more; 71% vs 46%, p < 0.05); and had a significantly higher cesarean section rate (33% vs 3%; p < 0.001). Only 10% (2 of 21) of c ase mothers met The American College of Obstetricians and Gynecologist s guideline for chemoprophylaxis. CONCLUSION: The American College of Obstetricians and Gynecologists guideline for chemoprophylaxis identif ies only 10% of women whose term newborns contract early-onset group B streptococcal sepsis.