Piffer Silvano, Rizzello Roberto, Pedron Mariangela, Dellanna Laura, Lauriola Anna Lina
Clinical and Evaluational Epidemiology Service. Provincial Health Agency, Trento, Italy.
Obstetrics and Gynaecology Unit, Ospedale S. Chiara Trento. Provincial Health Agency, Trento, Italy.
Infez Med. 2022 Jun 1;30(2):254-262. doi: 10.53854/liim-3002-11. eCollection 2022.
The study analyzes the trend of group B streptococcal (GBS) infection in pregnancy in the province of Trento, Italy, where a universal screening of GBS infection in pregnancy has been active for some time. Data from pregnant women who gave birth at local maternity units between 2015-2019 were obtained from birth attendance certificates (BAC), the main - and mandatory - source of information for monitoring pregnancies, births and neonatal health in Italy. The BAC used in the province of Trento acquires the results of a vast range of infections in pregnancy. The data collected from the BAC were integrated with those provided by the Hospital Information System (SIO). The occurrence of neonatal GBS infection was investigated on 2019 birth cohort, using the hospital discharge archive as an ancillary information source. Between 2015-2019, 20,905 pregnant women received care at maternity units of the province of Trento, Italy, of whom 25.5% were foreigners. The average coverage of GBS testing in pregnancy was 91.8% (95% CI 91.25-92.35) without significant variations from one year to the next. Test coverage varies in relation to maternity units and some socio-demographic characteristics of mothers. The average proportion of GBS positive cases over the study period was 21.0% (95% CI 20.7-21.3), a value that does not show statistically significant changes from one year to the next. The proportion of positive cases appears uneven among the subgroups of pregnant women considered, even if the differences are not statistically significant. In the 2019 birth cohort, newborns to GBS-positive mothers had an excess of stillbirths, of those born with Apgar at 5 minutes <7 and hospitalized at birth. However, these excesses were not statistically significant. Intravenous Antibiotic Prophylaxis (IAP) was performed in 86.8% of births from GBS positive mothers who had an indication for IAP. IAP was inadequate in 7.4% of the GBS positive mothers. Postnatal evaluation of 783 live births to GBS positive mothers identified 3 cases of early neonatal GBS infection. The incidence of neonatal GBS infection over the whole series of live births is 0.71/1,000 (95% CI 0.56-0.86), 0.68/1000 (CI 95% 0.55-0.79) in Italians and 1.07/1000 (95% CI 0.45-1.65) in foreigners. Data collection on infections in pregnancy through BAC allows area-based assessment. The quality of the data recorded in the BAC can be considered satisfactory but it was necessary to access to other information sources. The local availability of various information sources should allow periodic audits and closer monitoring of neonatal GBS infection.
该研究分析了意大利特伦托省孕期B族链球菌（GBS）感染的趋势，在该省，孕期GBS感染的普遍筛查已开展了一段时间。2015年至2019年间在当地产科单位分娩的孕妇数据来自出生登记证书（BAC），这是意大利监测妊娠、分娩和新生儿健康的主要且强制性的信息来源。特伦托省使用的BAC获取了孕期多种感染的结果。从BAC收集的数据与医院信息系统（SIO）提供的数据相结合。利用医院出院档案作为辅助信息来源，对2019年出生队列中的新生儿GBS感染情况进行了调查。2015年至2019年间，20905名孕妇在意大利特伦托省的产科单位接受护理，其中25.5%为外国人。孕期GBS检测的平均覆盖率为91.8%（95%可信区间91.25 - 92.35），各年份之间无显著差异。检测覆盖率因产科单位以及母亲的一些社会人口学特征而异。研究期间GBS阳性病例的平均比例为21.0%（95%可信区间20.7 - 21.3），该值各年份之间无统计学显著变化。在所考虑的孕妇亚组中，阳性病例比例似乎不均衡，尽管差异无统计学意义。在2019年出生队列中，GBS阳性母亲的新生儿在死产、5分钟阿氏评分<7分且出生时住院方面存在超额情况。然而，这些超额情况无统计学意义。86.8%有IAP指征的GBS阳性母亲分娩时进行了静脉抗生素预防（IAP）。7.4%的GBS阳性母亲的IAP不充分。对783名GBS阳性母亲的活产儿进行产后评估，发现3例早期新生儿GBS感染。整个活产儿系列中新生儿GBS感染的发生率为0.71/1000（95%可信区间0.56 - 0.86），意大利人为0.68/1000（95%可信区间0.55 - 0.79），外国人为1.07/1000（95%可信区间0.45 - 1.65）。通过BAC收集孕期感染数据可进行基于地区的评估。BAC中记录的数据质量可认为是令人满意的，但有必要获取其他信息来源。各种信息来源在当地的可获取性应有助于定期审计并更密切地监测新生儿GBS感染。
