RISK INDICATORS FOR NEONATAL EARLY-ONSET GBS-RELATED DISEASE - A CASE-CONTROL STUDY

Risk indicators play an important role in the active prevention of neo natal Early-Onset GBS-related Disease (EOD). We studied the associatio ns between potential risk indicators and the occurrence of EOD by mean s of a case-control study. All cases of EOD delivered in the Academic Medical Centre in Amsterdam between January 1988 and December 1995 wer e included. For each case we selected 3 controls, matched for date and time of birth. The association between continuous risk indicators and the occurrence of EOD was assessed using spline functions. Multivaria ble logistic regression analysis was performed to determine which risk indicators contributed independently. Forty-one cases were compared w ith 123 controls. In the multivariable analysis, gestational age < 37 weeks and intrapartum temperature greater than or equal to 37.4 degree s C showed to be statistically significant risk indicators for EOD, wi th odds ratios of 2.5 per week gestation and 1.6 per 0.1 degrees C, re spectively. After cesarean section the risk of EOD was significantly d ecreased (OR 0.13). Of the other potential risk indicators only prelab or rupture of membranes showed an increased risk, although the associa tion was not statistically significant. Prolonged duration of ruptured membranes had no additional merit. Risk indicators that should be tak en into account in strategies to prevent EOD are increased maternal te mperature and decreased gestational age.