Schuchat Anne, Roome Aaron, Zell Elizabeth R, Linardos Heather, Zywicki Sara, O'Brien Katherine L
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Matern Child Health J. 2002 Jun;6(2):107-14. doi: 10.1023/a:1015416324579.
To determine levels of prenatal screening for several infections, intrapartum recognition of risk factors, and prophylaxis against mother-to-child transmission of group B streptococcus.
Review of stratified random sample of hospital records for deliveries in Connecticut during 1996. SUDAAN analysis was used to adjust for the complex survey design, and weighting adjusted for the probability of being sampled and nonresponse.
Of 992 records requested, 868 (88%) were abstracted and analyzed. Thirty-six percent of women had prenatal screening for group B streptococcus and 26% had been tested for human immunodeficiency virus (HIV), while 97-99% of women had been screened prenatally for hepatitis B surface antigen, rubella, and syphilis. Of those women tested, 17% were detected as group B streptococcus carriers, and 78% of these received intrapartum antibiotic prophylaxis. Among women who were not screened for group B streptococcus prenatally, 22% met risk-based criteria for prophylaxis, but only 45% of these received intrapartum prophylaxis. Among unscreened women with a risk factor, those with shorter hospital stays prior to delivery, admitted on evening or night shifts, or who delivered on the weekend were significantly less likely to receive intrapartum prophylaxis.
In 1996, the majority of women who delivered in Connecticut were not tested prenatally for group B streptococcus and the majority of those not tested in whom there was an indication for prophylaxis were not treated. Compliance with group B streptococcus prevention recommendations can be improved through increased prenatal testing and/or better recognition of risk-based criteria for intrapartum prophylaxis.
确定几种感染的产前筛查水平、产时危险因素的识别情况以及预防B族链球菌母婴传播的情况。
回顾1996年康涅狄格州医院分娩记录的分层随机样本。采用SUDAAN分析来调整复杂的调查设计，并根据抽样概率和无应答情况进行加权调整。
在索要的992份记录中，868份（88%）被提取并分析。36%的女性进行了B族链球菌产前筛查，26%的女性进行了人类免疫缺陷病毒（HIV）检测，而97 - 99%的女性进行了乙肝表面抗原、风疹和梅毒的产前筛查。在接受检测的女性中，17%被检测为B族链球菌携带者，其中78%接受了产时抗生素预防。在未进行B族链球菌产前筛查的女性中，22%符合基于风险的预防标准，但其中只有45%接受了产时预防。在有危险因素的未筛查女性中，分娩前住院时间较短、在傍晚或夜间班次入院或在周末分娩的女性接受产时预防的可能性显著降低。
1996年，在康涅狄格州分娩的大多数女性未进行B族链球菌产前检测，大多数有预防指征但未检测的女性未得到治疗。通过增加产前检测和/或更好地识别基于风险的产时预防标准，可以提高对B族链球菌预防建议的依从性。
