RESUMO
Because of high rates of neonatal gram-negative sepsis in many Latin American countries, we prospectively enrolled 784 high-risk pregnant women in a study designed to evaluate the effect of a single 1-g dose of ceftriaxone (n = 390) vs. that of no antibiotic prophylaxis (n = 394) on oral, rectal, and umbilical colonization and fatality rates among newborn infants. The mean ceftriaxone concentration in cord blood samples was 26 microgram/mL (range, 9-40 microgram/mL). Compared with infants of untreated mothers, children born to women who were given ceftriaxone were colonized at a lesser rate by gram-negative bacilli (54% vs. 35%; P < .001) and by group B streptococci (54% vs. 21%; P = .03) and endured significantly fewer sepsis-like illnesses in the first 5 days of life (8.1% vs. 3.1%; P = .004). There was also a tendency for them to have fewer episodes of culture-proven early-onset sepsis (2.8% vs. 0.5%; P = .06). Sepsis-related case-fatality rates (0.8% and 0.3%, respectively) were not significantly different. Although intrapartum administration of a single dose of ceftriaxone to high-risk mothers could be a safe and potentially useful strategy for reducing early-onset neonatal infections, additional information is required before this approach can be recommended for routine prophylaxis.
Assuntos
Infecções Bacterianas/prevenção & controle , Ceftriaxona/uso terapêutico , Sepse/prevenção & controle , Infecções Bacterianas/mortalidade , Infecções Bacterianas/transmissão , Ceftriaxona/efeitos adversos , Ceftriaxona/sangue , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doenças Infecciosas , Triagem Neonatal , Gravidez , Estudos Prospectivos , Sepse/mortalidade , Sepse/transmissão , Resultado do TratamentoRESUMO
The incidence of low-birth weight babies in the Santo Tomás maternity ward was 9% between the first of August of 1992 and the 31 of July of 1993. We found a higher risk of having low birth weight babies if the mother was toxemic, without prenatal care of low socioeconomic status and if she was single. We did not find an association with adolescence, short mother's height, low educational status and primi- or multiparity of 5 or more
Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Recém-Nascido de Baixo Peso , Complicações na Gravidez/epidemiologia , Cuidado Pré-Natal , Fatores Socioeconômicos , Idade Materna , Incidência , Panamá/epidemiologia , Paridade , Índice de ApgarRESUMO
The incidence of low-birth weight babies in the Santo Tomás maternity ward was 9% between the first of August of 1992 and the 31 of July of 1993. We found a higher risk of having low birth weight babies if the mother was toxemic, without prenatal care of low socioeconomic status and if she was single. We did not find an association with adolescence, short mother's height, low educational status and primi- or multiparity of 5 or more.