Alberto Berardi1, Cecilia Rossi2, Maria Letizia Bacchi Reggiani3, Annalisa Bastelli4, Maria Grazia Capretti5, Claudio Chiossi6, Valentina Fiorini7, Lucia Gambini8, Sara Gavioli2, Marcello Lanari9, Luigi Memo10, Irene Papa11, Luana Pini12, Maria Vittoria Rizzo13, Andrea Zucchini14, Fabio Facchinetti15, Fabrizio Ferrari1. 1. a Unità Operativa di Terapia Intensiva Neonatale, Dipartimento Integrato Materno-Infantile, Azienda Ospedaliero-Universitaria Policlinico , Modena , Italy. 2. b Terapia Intensiva Neonatale, Dipartimento Ostetrico e Pediatrico, Istituto di Ricovero e Cura a Carattere Scientifico IRCCS, Arcispedale Santa Maria Nuova , Reggio Emilia , Italy. 3. c Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Azienda Ospedaliero Universitaria S. Orsola-Malpighi , Bologna, Italy. 4. d Unità Operativa di Terapia Intensiva Neonatale, Dipartimento Materno Infantile, Ospedale Maggiore , Bologna, Italy. 5. e Unità Operativa di Neonatologia, Dipartimento del bambino, della donna e delle malattie urologiche, Azienda Ospedaliero Universitaria S. Orsola-Malpighi , Bologna, Italy. 6. f Unità Operativa di Pediatria, Ospedale Civile , Sassuolo , Italy. 7. g Unità Operativa di Pediatria, Ospedale B Ramazzini , Carpi, Italy. 8. h Unità Operativa di Terapia Intensiva Neonatale, Azienda Ospedaliero-Universitaria Policlinico , Parma , Italy. 9. i Unità Operativa di Pediatria e Neonatologia, Ospedale Santa Maria della Scaletta , Imola , Italy. 10. j Unità Operativa di Pediatria, Ospedale San Martino , Belluno , Italy. 11. k Unità Operativa di Terapia Intensiva Neonatale, Ospedale Infermi , Rimini , Italy. 12. l Unità Operativa di Pediatria, Ospedale Civile , Lugo , Italy. 13. m Unità Operativa di Terapia Intensiva Neonatale e Pediatrica, Ospedale Civile M. Bufalini , Cesena , Italy. 14. n Unità Operativa di Pediatria, Ospedale Civile , Faenza , Italy , and. 15. o Unità Operativa di Ostetricia, Dipartimento Integrato Materno-Infantile, Azienda Ospedaliero-Universitaria Policlinico , Modena , Italy.
Abstract
INTRODUCTION: The prevalence of maternal group-B-streptococcus (GBS) colonization and risk factors (RFs) for neonatal early-onset disease (EOD) in Europe are poorly defined. Large-scale information concerning adherence to recommendations for preventing GBS-EOD are lacking. MATERIALS AND METHODS: This was a 3-month retrospective area-based study including all regional deliveries ≥35 weeks' gestation (in 2012). The sensitivity, specificity, positive and negative predictive values, odds ratio and receiver operating characteristic (ROC) curve for intrapartum antibiotic prophylaxis (IAP) among full-term and preterm deliveries and prolonged membrane rupture (PROM) were calculated. RESULTS: Among 7133 women, 259 (3.6%) were preterm (35-36 weeks' gestation). Full-term women were 6874, and 876 (12.7%) had at least 1 RF. Most women (6495) had prenatal screening and 21.4% (1390) were GBS positive. IAP was given to 2369 (33.2%) women (preterm, n = 166; full term, n = 2203). Compared to full-term, preterm women were less likely to receive IAP when indicated (73.2% versus 90.3%, p < 0.01). Full-term women represented the largest area under the curve (AUC, 0.87). PROM showed the highest sensitivity (98.6%), but the lowest specificity (6.9%) and AUC (0.53). CONCLUSIONS: Large-scale prenatal screening and IAP are feasible. Women delivering preterm are less likely to receive IAP when indicated. Most unnecessary antibiotics are given in cases of PROM.
INTRODUCTION: The prevalence of maternal group-B-streptococcus (GBS) colonization and risk factors (RFs) for neonatal early-onset disease (EOD) in Europe are poorly defined. Large-scale information concerning adherence to recommendations for preventing GBS-EOD are lacking. MATERIALS AND METHODS: This was a 3-month retrospective area-based study including all regional deliveries ≥35 weeks' gestation (in 2012). The sensitivity, specificity, positive and negative predictive values, odds ratio and receiver operating characteristic (ROC) curve for intrapartum antibiotic prophylaxis (IAP) among full-term and preterm deliveries and prolonged membrane rupture (PROM) were calculated. RESULTS: Among 7133 women, 259 (3.6%) were preterm (35-36 weeks' gestation). Full-term women were 6874, and 876 (12.7%) had at least 1 RF. Most women (6495) had prenatal screening and 21.4% (1390) were GBS positive. IAP was given to 2369 (33.2%) women (preterm, n = 166; full term, n = 2203). Compared to full-term, preterm women were less likely to receive IAP when indicated (73.2% versus 90.3%, p < 0.01). Full-term women represented the largest area under the curve (AUC, 0.87). PROM showed the highest sensitivity (98.6%), but the lowest specificity (6.9%) and AUC (0.53). CONCLUSIONS: Large-scale prenatal screening and IAP are feasible. Women delivering preterm are less likely to receive IAP when indicated. Most unnecessary antibiotics are given in cases of PROM.
Entities:
Keywords:
Group B streptococcus; intrapartum antibiotic prophylaxis; newborn; prevention; risk factors; sepsis