OBJECTIVE: To estimate if neonates with early-onset group B streptococcus (GBS) sepsis have clinical evidence of fetal infection during labor or at delivery. METHODS: Retrospective cohort study of all neonates diagnosed with GBS sepsis by culture and clinical findings within the first 72 hours of life from January 1, 2000, through December 31, 2008, at Parkland Health and Hospital System. Medical records were reviewed and maternal, neonatal, and delivery data were ascertained. These neonates then were compared with all neonates delivered during the same time period. RESULTS: During the study period, 143,384 live-born neonates were delivered at our institution; 94 were diagnosed with early-onset GBS sepsis. The majority of these neonates (n=93) were diagnosed with early-onset GBS within the first hour of life. Neonates with early-onset GBS sepsis had a significant increase in preterm delivery, cesarean delivery (total and for fetal distress), 1- and 5-minute Apgar scores of 3 or lower, umbilical cord pH less than 7.0, and a base deficit of 12 mmol/L or higher. In addition, nulliparity differed between those with early-onset GBS and those without (74% compared with 33%, P<.001) as did chorioamnionitis rates (62% compared with 8%, P<.001). CONCLUSION: We believe that these findings are compelling evidence that fetuses with early-onset GBS may have signs of sepsis peripartum. We hypothesize that these data support the concept that early-onset GBS represents a spectrum of infection that often precedes birth.
OBJECTIVE: To estimate if neonates with early-onset group B streptococcus (GBS) sepsis have clinical evidence of fetal infection during labor or at delivery. METHODS: Retrospective cohort study of all neonates diagnosed with GBS sepsis by culture and clinical findings within the first 72 hours of life from January 1, 2000, through December 31, 2008, at Parkland Health and Hospital System. Medical records were reviewed and maternal, neonatal, and delivery data were ascertained. These neonates then were compared with all neonates delivered during the same time period. RESULTS: During the study period, 143,384 live-born neonates were delivered at our institution; 94 were diagnosed with early-onset GBS sepsis. The majority of these neonates (n=93) were diagnosed with early-onset GBS within the first hour of life. Neonates with early-onset GBS sepsis had a significant increase in preterm delivery, cesarean delivery (total and for fetal distress), 1- and 5-minute Apgar scores of 3 or lower, umbilical cord pH less than 7.0, and a base deficit of 12 mmol/L or higher. In addition, nulliparity differed between those with early-onset GBS and those without (74% compared with 33%, P<.001) as did chorioamnionitis rates (62% compared with 8%, P<.001). CONCLUSION: We believe that these findings are compelling evidence that fetuses with early-onset GBS may have signs of sepsis peripartum. We hypothesize that these data support the concept that early-onset GBS represents a spectrum of infection that often precedes birth.
Authors: Jonathan M Wortham; Nellie I Hansen; Stephanie J Schrag; Ellen Hale; Krisa Van Meurs; Pablo J Sánchez; Joseph B Cantey; Roger Faix; Brenda Poindexter; Ronald Goldberg; Matthew Bizzarro; Ivan Frantz; Abhik Das; William E Benitz; Andi L Shane; Rosemary Higgins; Barbara J Stoll Journal: Pediatrics Date: 2015-12-30 Impact factor: 7.124
Authors: Jessica A Sutton; Lisa M Rogers; Beverly R E A Dixon; Leslie Kirk; Ryan Doster; Holly M Algood; Jennifer A Gaddy; Rebecca Flaherty; Shannon D Manning; David M Aronoff Journal: Am J Reprod Immunol Date: 2019-01-30 Impact factor: 3.886
Authors: Celeste Beck; Kelly Gallagher; Leigh A Taylor; Jeffery A Goldstein; Leena B Mithal; Alison D Gernand Journal: Obstet Gynecol Date: 2021-06-01 Impact factor: 7.623
Authors: Neal J Russell; Anna C Seale; Catherine O'Sullivan; Kirsty Le Doare; Paul T Heath; Joy E Lawn; Linda Bartlett; Clare Cutland; Michael Gravett; Margaret Ip; Shabir A Madhi; Craig E Rubens; Samir K Saha; Stephanie Schrag; Ajoke Sobanjo-Ter Meulen; Johan Vekemans; Carol J Baker Journal: Clin Infect Dis Date: 2017-11-06 Impact factor: 9.079