Antibiotics in Pregnancy May Shield Newborns From Strep B
THURSDAY Jan. 5, 2012 -- Giving antibiotics to pregnant women at risk of streptococcus B infection greatly reduces infection rates in newborns, according to a new study.
Use of antibiotics to prevent group B strep is common in high-income nations and should also be used in developing countries, at least until a vaccine becomes available, said study author Dr. Karen Edmond, of the London School of Hygiene and Tropical Medicine in England, and colleagues.
The researchers analyzed dozens of previous studies and found that the mean global incidence of group B strep infection in infants up to 3 months old was 0.53 per 1,000 live births and the mean death rate was 10 percent.
Africa had the highest incidence (1.21 cases per 1,000 live births) and death rate (22 percent). Incidence in the Americas [0.67 per 1,000 live births] and Europe [0.57 per 1,000 live births] was also higher than the global average. The death rate was 11 percent in the Americas and 7 percent in Europe.
Worldwide, the death rate for early-onset group B strep infection -- occurring the first week of life -- was 12 percent, twice that of later-onset disease.
Sixty-nine percent of the studies reported use of any preventive antibiotic treatment in the time between labor and delivery (intrapartum). Rates of early-onset disease were three times lower in studies that reported preventive use of antibiotics than those that did not report such use.
The study appears in the Jan. 5 issue of The Lancet.
The most common strep B serotype in all regions was serotype III (49 percent), followed by serotypes Ia (23 percent), Ib (7 percent), II (6 percent), and V (9 percent).
The distribution of strains of strep B appears similar worldwide, which means that vaccines currently in development could have near-universal applicability, according to the researchers.
"A conjugate vaccine incorporating five serotypes (Ia, Ib, II, III, V) could prevent most global group B streptococcal disease," they wrote in a journal news release. Phase 3 trials of vaccines will soon begin in Africa, they said.
"Vaccination of pregnant women also has the potential to reduce premature births, stillbirths, and puerperal sepsis [a toxic condition] caused by group B streptococcus," the researchers said.
The U.S. Centers for Disease Control and Prevention has more about group B strep infections in newborns.
Posted: January 2012