Mortality from early neonatal group B streptococcal sepsis: influence of obstetric factors

Our objective was to determine if the neonatal mortality from early group B streptococcal (GBS) septicemia was associated with obstetric factors other than birthweight. Medical records from our institution for all neonates with positive blood cultures for GBS in the first 7 days of life between January 1981 and December 1992 were reviewed (n = 61). All the neonates had received broad-spectrum intravenous antibiotics within 3 h of birth, and all had cerebrospinal fluid (CSF) cultures obtained. In a multivariate model we found a significant association between neonatal mortality and birthweight (P = .01). The other significant associations were with positive CSF cultures (P = .01) and intrapartum invasive fetal scalp electrode monitoring (P = .03). After controlling for these and other variables in the model, the odds of death for the infants with scalp electrode monitoring was 8 times greater (95% CI = 1.1,56), compared to those who had the GBS septicemia but no intrapartum fetal scalp electrode monitoring. In conclusion, the association we found between neonatal fatality from early GBS septicemia and invasive fetal scalp electrode monitoring is plausible and needs further study.