The effect of prophylactic antibiotics prior to catheter balloon insertion on clinical chorioamnionitis in GBS-colonized term pregnancies

IF 2.3 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2026-02-20 Epub Date: 2025-12-17 DOI:10.1016/j.ejogrb.2025.114898

Raneen Abu Shqara , Sabaa Knaneh , Roni Jeremias Laskar , Lior Lowenstein , Enav Yefet , Maya Frank Wolf

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引用次数: 0

Abstract

Objective

To compare the risk of clinical chorioamnionitis at delivery among patients with Group B Streptococcus (GBS) colonization undergoing induction of labor (IOL) with catheter balloon insertion, according to two protocols.

Methods

We conducted a retrospective cohort study of patients with term singleton pregnancies undergoing IOL for medical indications at two tertiary centers. At Galilee Medical Center, positive GBS colonization prompted intravenous ampicillin (2 g every 6 h) starting 30 min prior to catheter balloon insertion and continued until delivery (early antibiotic prophylaxis group). At Tzafon Medical Center, antibiotics were administered according to standard guidelines at the onset of active labor or rupture of membranes (routine intrapartum antibiotic prophylaxis (IAP) group). The primary outcome was clinical chorioamnionitis. Secondary outcomes included postpartum infectious morbidity, delivery mode, and neonatal outcomes.

Results

Of 144 patients, 75 received early prophylactic antibiotics and 69 received routine IAP. Baseline maternal and obstetric characteristics were comparable. For the early prophylactic antibiotics vs. the routine IAP group, prevalences were lower of clinical chorioamnionitis (0.0 % vs. 8.7 %, p = 0.002) and maternal fever (2.7 % vs. 15.9 %, p = 0.005). Statistically significant differences were not observed in postpartum infections, cesarean delivery rates (16.0 % vs. 26.1 %, p = 0.136), or neonatal outcomes. On multivariate analysis, routine IAP administration compared with early prophylactic antibiotics was independently associated with an increased risk of clinical chorioamnionitis (adjusted odds ratio 9.43, 95 % confidence interval 1.66–53.45, p = 0.01).

Conclusion

Prophylactic antibiotics administered prior to catheter balloon insertion in patients with GBS colonization were associated with a lower risk of clinical chorioamnionitis.

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导管球囊插入前预防性抗生素对gbs定植足月妊娠临床绒毛膜羊膜炎的影响。

目的：比较B群链球菌（GBS）定植引产（IOL）患者分娩时临床绒毛膜羊膜炎的风险，并根据两种方案进行导尿管球囊置入。方法：我们对在两个三级医疗中心接受人工晶状体治疗的单胎妊娠足月患者进行回顾性队列研究。在加利利医疗中心，GBS定植阳性提示在导管球囊插入前30分钟开始静脉注射氨苄西林（每6小时2克），并持续到分娩（早期抗生素预防组）。在Tzafon医疗中心，在活动性分娩或胎膜破裂开始时，根据标准指南给予抗生素（常规产时抗生素预防（IAP）组）。主要结局为临床绒毛膜羊膜炎。次要结局包括产后感染发病率、分娩方式和新生儿结局。结果：144例患者中，75例接受早期预防性抗生素治疗，69例接受常规抗生素治疗。基线产妇和产科特征具有可比性。与常规IAP组相比，早期预防性抗生素组临床绒毛膜羊膜炎（0.0%比8.7%,p = 0.002）和产妇发热（2.7%比15.9%,p = 0.005）的患病率较低。在产后感染、剖宫产率（16.0%对26.1%,p = 0.136）或新生儿结局方面未观察到统计学上的显著差异。多因素分析显示，常规IAP给药与早期预防性抗生素相比，与临床羊膜炎风险增加独立相关（校正优势比9.43,95%可信区间1.66 ~ 53.45,p = 0.01）。结论：GBS定植患者在导管球囊插入前给予预防性抗生素与临床绒毛膜羊膜炎的风险较低相关。

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.