Incidence of maternal GBS colonization and neonatal GBS disease among Very Low Birth Weight Polish neonates
Monika Brzychczy-Wloch, Jadwiga Wojkowska-Mach, Ewa Helwich, Piotr B. Heczko
Med Sci Monit 2013; 19:34-39
Available online: 2013-01-11
Background: In 2008, the Polish Gynecological Society issued recommendations to screen pregnant women for GBS colonization and offer antibiotic prophylaxis at delivery. The goal of this study was to assess compliance with these recommendations among women delivering very low birth weight infants (VLBW) in Poland.
Material/Methods: The 6 Polish Perinatological Institutions managing infections in the framework of the Polish Perinatological Network were subjected to the analysis. A retrospective case-cohort study for 2009 was conducted using the standard protocols and definitions. The collected data pertained to 812 pregnant women who gave birth to 910 babies with VLBW.
Results: The statistical variation across the 6 studied centers associated with GBS prevention of infections was noted. Bacteriological examinations of samples taken from the vagina were performed only in 273 (34%) of the women, ranging between 2% and 93%, depending on the center. GBS carriage was proven in 19% of these women, ranging between 8% and 27%. The culture method was inadequate because of highly variable results. It was found that the rate of GBS determination is statistically connected with the number of women’s screenings performed in the study centers. The intrapartum antibiotic prophylaxis (IAP) was used only in the half of GBS-positive women (47%). Six cases of early-onset GBS infections (5 blood stream infections and 1 pneumonia) were registered in the studied newborns, of which 4 neonates were born to women who received IAP against GBS. The incidence rate of GBS infection in VLBW neonates was 6.6 per 1000 live births, with a high death rate (up to 33%).
Conclusions: Poor compliance with GBS screening and antibiotic prevention were observed among women delivering very low birth weight infants. GBS infection was noted in a significant proportion of VLBW neonates; we believe a uniform policy should be put in place to manage these high-risk women and babies.
Keywords: Pregnancy Complications, Infectious - microbiology, Poland - epidemiology, Pregnancy, Infant, Very Low Birth Weight, Infant, Newborn, Diseases - microbiology, Infant, Newborn, Incidence, Genitalia, Female - microbiology, Colony Count, Microbial, Antibiotic Prophylaxis, Anti-Bacterial Agents - therapeutic use, Streptococcal Infections - microbiology, Streptococcus agalactiae - growth & development