GBS Intrapartum Chemoprophylaxis

Obstetric factors found to be asociated with increased risk of early onset GBS include birth at less than 37 wk GA, ROM of 18 or more hours and intrapartum fever (> 100.4 F).  The incidence of GBS disease is also increased in women with heavy GBS colonization, h/o GBS bactiuria during pregnancy, African-American descent, maternal age less than 20 years, ROM prior to onset of labor, and low serum concentration of anti-GBS antibody.

The 1997 AAP Recommendations are as follows:
 

Intrapartum penicillin should be administered under any of the following conditions 
  • Positive risk factors
    • Previous infant with GBS disease (regardless of current culture status)
    • GBS bactiuria at any time during the present pregnancy
    • Delivery at less than 37 weeks GA (unless negative Cx at 35-37 wks)
  • Positive GBS rectal or vaginal Cx at 35-37 weeks
  • Culture results unknown, incomplete, or not done AND either
    • Intrapartum temperature greater than 38oC (100.4oF).

      • Greater than 18 hours ROM
 
based on the AAP Guideslines appearing in Pediatrics 99(3):489-496.

see also: Guidelines for Management of Newborns
 
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Last modification: July 8, 1999