Bramer S, van Wijk F H, Mol B W, Adriaanse A H
Department of Obstetrics and Gynecology, University of Amsterdam, The Netherlands.
J Perinat Med. 1997;25(6):469-75. doi: 10.1515/jpme.1997.25.6.469.
Risk indicators play an important role in the active prevention of neonatal Early-Onset GBS-related Disease (EOD). We studied the associations between potential risk indicators and the occurrence of EOD by means of a case-control study. All cases of EOD delivered in the Academic Medical Centre in Amsterdam between January 1988 and December 1995 were included. For each case we selected 3 controls, matched for date and time of birth. The association between continuous risk indicators and the occurrence of EOD was assessed using spline functions. Multivariable logistic regression analysis was performed to determine which risk indicators contributed independently. Forty-one cases were compared with 123 controls. In the multivariable analysis, gestational age < 37 weeks and intrapartum temperature > or = 37.4 degrees C showed to be statistically significant risk indicators for EOD, with odds ratios of 2.5 per week gestation and 1.6 per 0.1 degree C, respectively. After cesarean section the risk of EOD was significantly decreased (OR 0.13). Of the other potential risk indicators only prelabor rupture of membranes showed an increased risk, although the association was not statistically significant. Prolonged duration of ruptured membranes had no additional merit. Risk indicators that should be taken into account in strategies to prevent EOD are increased maternal temperature and decreased gestational age.
风险指标在新生儿早发型B族链球菌相关疾病（EOD）的主动预防中发挥着重要作用。我们通过病例对照研究探讨了潜在风险指标与EOD发生之间的关联。纳入了1988年1月至1995年12月在阿姆斯特丹学术医疗中心分娩的所有EOD病例。对于每例病例，我们选取3名对照，根据出生日期和时间进行匹配。使用样条函数评估连续风险指标与EOD发生之间的关联。进行多变量逻辑回归分析以确定哪些风险指标具有独立作用。将41例病例与123名对照进行比较。在多变量分析中，孕周<37周和产时体温≥37.4℃显示为EOD的统计学显著风险指标，每周孕周的比值比为2.5，每0.1℃的比值比为1.6。剖宫产术后EOD风险显著降低（比值比0.13）。在其他潜在风险指标中，只有胎膜早破显示风险增加，尽管该关联无统计学意义。胎膜破裂时间延长并无额外影响。预防EOD策略中应考虑的风险指标是产妇体温升高和孕周降低。
