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Am J Obstet Gynecol ; 181(5 Pt 1): 1197-202, 1999 Nov.
Article de Anglais | MEDLINE | ID: mdl-10561645

RÉSUMÉ

OBJECTIVE: In mid-1996 and early 1997, the Centers for Disease Control and Prevention, The American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics all published guidelines outlining 2 potential strategies for the purpose of preventing neonatal sepsis caused by group B Streptococcus. One of these approaches involves treating pregnant women intrapartum with antibiotics if any of the following risk factors develop: delivery at <37 weeks' gestation, membrane rupture for >/=18 hours' duration, or temperature during labor of >/=38 degrees C. However, to date there have been no population-based studies that have ascertained the percentage of pregnant women eligible to receive intrapartum antibiotic chemoprophylaxis if these risk factors were used. Our objective was to perform a large patient-based study at >1 institution evaluating all deliveries for the presence of maternal risk factors by using the definitions of the current guidelines. STUDY DESIGN: A prospective cohort study was initiated in 1995 at 3 private community hospitals and 1 private referral center. The study population was composed of 5410 consecutively delivered patients from the 4 different hospitals. Every pregnancy was analyzed for gestational age at delivery, duration of membrane rupture, temperature during labor, and use of intrapartum antibiotic chemoprophylaxis. RESULTS: Of the 5410 patients, a total of 455 (8. 4%) were delivered of their neonates before 37 weeks' gestation, 421 (7.8%) had rupture of membranes for at least 18 hours' duration, and 378 (7.0%) had an intrapartum temperature of >/=38 degrees C. Overall, 1071 pregnant women (19.8% of the population studied) had >/=1 of the defined risk factors. CONCLUSIONS: These data suggest that, if the current risk factor strategy is used, 19.8% of the delivering population would potentially be candidates for intrapartum antibiotic chemoprophylaxis.


Sujet(s)
Maladies néonatales/traitement médicamenteux , Maladies néonatales/prévention et contrôle , Sepsie/embryologie , Sepsie/prévention et contrôle , Infections à streptocoques/embryologie , Infections à streptocoques/prévention et contrôle , Âge de début , Antibactériens/usage thérapeutique , Études de cohortes , Accouchement (procédure) , Femelle , Âge gestationnel , Humains , Incidence , Nouveau-né , Maladies néonatales/épidémiologie , Maladies néonatales/microbiologie , Prématuré , Travail obstétrical/physiologie , Guides de bonnes pratiques cliniques comme sujet , Grossesse , Issue de la grossesse , Études prospectives , , Facteurs de risque , Sepsie/traitement médicamenteux , Sepsie/épidémiologie , Infections à streptocoques/traitement médicamenteux , Infections à streptocoques/épidémiologie , Streptococcus agalactiae/physiologie , Température , Facteurs temps
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