While intrapartum antibiotics for Group B streptococcus reduces infant colonization it does not reduce infant mortality.

WITHDRAWN. Intrapartum antibiotics for Group B streptococcal colonisation.

Fiona M Smaill

Cochrane Database Syst Rev

Jan 1, 2010

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Abstract

BACKGROUND: Group B streptococcal infection is common in pregnant women without causing harm. However it is also a significant cause of neonatal morbidity and mortality. OBJECTIVES: The objective of this review was to assess the effects of intrapartum administration of antibiotics to women on infant colonization with group B streptococcus, early onset neonatal group B streptococcus sepsis and neonatal death from infection. SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register was searched. SELECTION CRITERIA: Controlled trials of pregnant women colonized with group B streptococcus comparing intrapartum antibiotic administration with no treatment, and providing data on infant colonization with group B streptococcus and/or neonatal infection. DATA COLLECTION AND ANALYSIS: Eligibility and trial quality assessment were done by one reviewer. MAIN RESULTS: Five trials were included. Overall quality was poor, with potential selection bias in all the identified studies. Intrapartum antibiotic treatment reduced the rate of infant colonization (odds ratio 0.10, 95% confidence interval 0.07 to 0.14) and early onset neonatal infection with group B streptococcus (odds ratio 0.17, 95% confidence interval 0.07 to 0.39). A difference in neonatal mortality was not seen (odds ratio 0.12, 95% confidence interval 0.01 to 2.00). AUTHORS' CONCLUSIONS: Intrapartum antibiotic treatment of women colonized with group B streptococcus appears to reduce neonatal infection. Effective strategies to detect maternal colonization with group B streptococcus and better data on maternal risk factors for neonatal group B streptococcus infection in different populations are required.

Affiliation

Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Room 2N16, 1200 Main Street West, Hamilton, Ontario, Canada, L8N 3Z5.