Intrapartum antibiotics and neonatal invasive infections caused by organisms other than group B streptococcus

Administration of group B streptococcal (GBS) antibiotic prophylaxis to women in labor has dramatically reduced the incidence of GBS neonatal disease, but there is little information on its impact on neonatal infections caused by other organisms. We conducted a nested case-control study to define the association between maternal intrapartum antibiotics and risk of neonatal non-GBS infection.

In our study population, 114 of 13,224 infants had 115 non-GBS infections. The incidence of non-GBS neonatal infections fell during the study period, ranging from an attack rate of 9.6 per 1000 infants in 1990 to 1992 to 8.0 per 1000 infants in 1996 to 1998, although this trend was not statistically significant (P >.05). The unadjusted association between neonatal infection and GBS prophylaxis was 0.89 (95% CI, 0.29, 2.6) and between neonatal infection and maternal intrapartum antibiotic due to any cause was 1.3 (95% CI, 0.65, 2.8).

The current policy of GBS maternal prophylaxis does not appear to convey excess risk of non-GBS infection to neonates.