ABSTRACT
We examined early-onset newborn group B streptococcal (GBS) infection amongthe population
of a large obstetric center in western Canada for the contemporary period 1987 to
1992. Attack rates for “definite” (bacteremic) and “presumptive” (urine group B antigen
positive with clinical evidence) GBS infections were 0.85 and 0.90 per 1000. Ten GBS-associated
stillbirths were recorded. Seven deaths occurred among bacteremic newborns (18.4%).
Using definitions of Boyer and Gotoff,3 87.2% of all mothers with infected newborns manifested at least one risk factor,
and 69.8% of all febrile pregnancies with either definition of infected newborn and
61.9% of a subset of the same with bacteremic offspring had maternal temperature 38°C
or higher prior to delivery. For our population, recommendations for universal antepartum
GBS screening and intrapartum prophylaxis must be discussed in the context of an existing
low frequency of bacteremic disease and with the understanding that fever in pregnancy
may be enough to warrant greater intervention that might further reduce the rate of
infection.
Keywords
Streptococci - sepsis - neonatal
