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Intrapartum antibiotics for group B streptococcal colonisation.
1Department of Pathology and Molecular Medicine, McMaster University Medical Centre, Hamilton Health Sciences Corporation, Room 2N29, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5. smaill@mcmaster.ca.
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Intrapartum antibiotics for pregnant women colonized with group B Streptococcus (GBS) significantly reduce infant GBS colonization and early-onset neonatal infection. However, this treatment did not show a significant impact on neonatal mortality rates.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Group B Streptococcus (GBS) colonization is common in pregnant women.
- GBS infection poses a significant risk for neonatal morbidity and mortality.
Purpose of the Study:
- To evaluate the impact of intrapartum antibiotics on infant GBS colonization.
- To assess the effect on early-onset neonatal GBS sepsis.
- To determine the influence on neonatal death due to infection.
Main Methods:
- Systematic review of controlled trials from the Cochrane Pregnancy and Childbirth Group trials register.
- Included trials compared intrapartum antibiotics versus no treatment in GBS-colonized pregnant women.
- Data on infant colonization and neonatal infection were analyzed.
Main Results:
- Five trials with poor overall quality and potential bias were included.
- Intrapartum antibiotics significantly reduced infant GBS colonization (OR 0.10; 95% CI 0.07-0.14).
- Early-onset neonatal GBS infection rates were also reduced (OR 0.17; 95% CI 0.07-0.39), but neonatal mortality was not significantly affected (OR 0.12; 95% CI 0.01-2.00).
Conclusions:
- Intrapartum antibiotic administration appears effective in reducing neonatal GBS infection.
- Improved strategies for detecting maternal GBS colonization are needed.
- Further research on maternal risk factors for neonatal GBS infection in diverse populations is required.