Analysis of different prophylaxis methods against early neonatal GBS infection.

Research aim- Analyse the use of different prophylaxis measures against early neonate infection, caused by group B streptococcus (GBS), and to analyse risk factors for the early neonate infection in Lithuanian university for health sciences hospital Kaunas clinics (LUHSH KC). Research contingent and methods -a retrospective analysis of case histories of women, who delivered in LUHSH KC, and of their newborns, who were treated in the LUHSH KC Department of Neonatolgy, was performed. Time intervals: 2012.01.01 – 2012.06.30 (interval, when the prophylactic measures against early neonate GBS infection were based on risk factors ) and 2014.01.01-.2014.06.30 (interval, when the screening for GBS was performed in pregnant women). In 2012 were selected 82 newborns and 80 mothers. In 2014 139 newborns and their 124 mothers were selected respectively. Demographics, risk factors, GBS colonisation, the course and outcome of the pregnancy for mothers and newborns were analysed, the accordance with the recomendations for early neonatal infection prevention as well as the incidence of early neonatal infection were assesed. Results – in 2012 m. GBS culture was obtained in 59 (73,8 %) women. 12 women (18,6 %) was GBS positive. In 2014 GBS culture was obtained in 96 women (77,4 %). 22 (22,9 %) women was GBS positive. 50 women (62,5 %) in 2012, and 83 women (66,9 %) in 2014 had at least one risk factor. In 2012 intrapartum fever occurred significantly more often (22,5 % versus 9,7%, p 0,05). Conclusions. 1. When applying prophylaxis, based on risk factors, against early GBS infection in 2012 and performing screening for GBS colonization in pregnant women the general incidence of early GBS infection risk factors was the same, however fever ≥38°C occurred more often in 2012. 2. Three out of four pregnant women were inspected for GBS colonization in 2012 as well as in 2014. GBS colonization in pregnant women in 2012 was 18,6 %, and in 2014 – 22,9 % (p>0,05). 3. In 2014 prophylaxis against early neonatal GBS infection was performed more often and during delivery antibiotics were administered more often according to national guidelines (65 % of cases) in comparison to 2012 (39,13 % of cases). 4. The tendency of decreased incidence for early neonatal sepsis was established in 2014, however the incidence of unspecified early neonatal infection was statistically significantly higher in comparison to 2012. There were no cases of early neonatal GBS sepsis. 5. The incidence of early neonatal infection was not related to the methods of prophylaxis against early neonatal GBS infection, to the application of these methods and to concordance with the national guidelines for early neonatal GBS infection