561 - Induction of labor, Intrapartum Antibiotic Exposure and Perinatal Outcomes in Group B Streptococcus Positive Mothers

Poster Number: 561

Ahmed Haggag, Michigan State University College of Human Medicine, East Lansing, MI, United States; Robert Long, Sparrow Hospital/Michigan State University College of Human Medicine, Lansing, MI, United States; Morgan Martin, Sparrow Hospital, Lansing, MI, United States; Shannon D. Manning, Michigan State University, East Lansing, MI, United States; Isoken N. Olomu, Michigan State University, Okemos, MI, United States

Background: The widespread implementation of intrapartum antibiotic prophylaxis (IAP) with penicillin in GBS-positive mothers has led to substantial reduction in early onset GBS disease; however, Escherichia coli is now emerging as a leading cause of early onset neonatal sepsis. Recent data suggest a growing tendency towards elective induction of labor (IOL) in uncomplicated pregnancies after 39 weeks. However, IOL is associated with longer admission-to-delivery intervals compared to spontaneous onset of labor. We hypothesize that GBS-positive, non-penicillin allergic mothers delivered by IOL are exposed to more doses of penicillin than mothers delivering spontaneously

Objective: 1) To determine if term, GBS-positive mothers delivered by IOL are exposed to more doses of penicillin than mothers delivered by spontaneous labor2) to compare maternal and neonatal characteristics and outcomes in the two modes of delivery.

Design/Methods: We performed a retrospective chart review of term, non-penicillin allergic, GBS-positive mothers who delivered vaginally from 6/1/2018 to 8/31/2021. Mothers and their infants delivered by IOL were compared to those delivered by spontaneous labor. The means were compared by group using unpaired two-tailed t-tests, categorical variables by Fisher’s exact test

Results: During the study period, 1,445 GBS-positive mothers were delivered vaginally at term; 661 (45.7%) by IOL, and 784 (54.3%) spontaneously. Mothers delivered by IOL received significantly more doses of penicillin (4.04 ± 1.99) than mothers delivered by spontaneous labor (2.23 ± 1.21, Table 1). The former also received penicillin for a significantly longer duration (15.35 ± 8.57 hours) than mothers delivering spontaneously (7.15 ± 5.38 hours). These differences were also noted when IOL and spontaneous delivery occurred at 39-41 weeks (Table 2). There was no difference in the rates of chorioamnionitis and neonatal intensive care unit admissionConclusion(s): In this study of GBS-positive mothers, IOL was linked to higher number of doses of penicillin than spontaneous labor, but no difference in in the rates of chorioamnionitis and neonatal intensive care unit admissions. Future work will focus on examining more specific clinical outcomes as enhanced penicillin exposure could have untoward implications for antimicrobial stewardship and the maternal and neonatal microbiota
Elective Induction, Intrapartum Antibiotic Exposure and Perinatal Outcomes in Group B Streptococcus Positive MothersAhmed Haggag CV.pdf
Induction of Labor, Intrapartum Antibiotic Exposure and Perinatal Outcomes in Group B Streptococcus (GBS) Positive Mothers