Prevention of excess neonatal morbidity associated with group B streptococci by vaginal chlorhexidine disinfection during labour

Burman, L. G.; Fryklund, B.; Helgesson, A.M.; Christensen, Poul; Christensen, Karen Kvist; Svenningsen, N. W.; Tullus, Kjell; Group, The Swedish Chlorhexidine Study

doi:10.1016/0140-6736(92)90393-h

Cited by 101 publications

(45 citation statements)

References 20 publications

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“…This problem can be overcome by using a sufficiently high concentration [18]. The chlorhexidine concentration used in our study was 600 times or more the minimal bactericidal concentration for GBS [28] and at least as high as in other clinical studies [19,20,22].…”

Section: Discussionmentioning

confidence: 81%

“…In 1992, the Swedish Chlorhexidine Study Group con cluded that intravaginal chlorhexidine flushing during labor reduced morbidity among full-term newborn in fants compared to placebo treatment with saline [22]. Parturients were cultured from the posterior fornix for GBS only.…”

Section: Discussionmentioning

confidence: 99%

“…In 1992, chlorhexidine disinfection during labor was reported to reduce excess neonatal morbidity associated with GBS [22], However, the effect on vertical transmis sion was not investigated. Stimulated by the promising results of a small clinical pilot study [20], we in vestigated the effect of vaginal chlorhexidine gel dis infection on vertical transmission of GBS in a randomized trial.…”

Section: Ah Adriaanse Et a I /European Journal Of Obstetrics And Gymentioning

confidence: 99%

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Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Adriaanse¹,

Kollée²,

Muytjens³

et al. 1995

European Journal of Obstetrics & Gynecology and Reproductiv

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Objective: To evaluate the effect of vaginal disinfection with chlorhexidine gel during labor on vertical transmission of group B streptococcus, as a method to prevent vertical transmission and subsequent neonatal early onset group B streptococcal disease. Study Design: A prospective study with randomization of 1020 parturients to one of three groups as soon as labor started. In all parturients, anus, introitus and cervix were cultured semiquantitatively. Two groups were treated double-blindly with 10 ml of either a 0.3% chlorhexidine gel or a placebo gel, applicated around the portio and into the fomices. If labor still continued, a second application was given after 10 h. The third group received no treatment. Ear, pharynx and umbilicus of all newborns were also cultured semiquantitatively. Results: Nine hundred and eighty one women were evaluated. The overall incidence of group B strep tococcal carriership was 19.4%. Vertical transmission was 52.4% in the chlorhexidine group, 71.4% in the placebo group and 66.7% in the control group (P = 0.069). When testing the transmission rates for the chlorhexidine versus the combined placebo plus control group (69.3%), the difference was 16.9% (P ~ 0.026). Conclusion: Vaginal disinfection with a chlorhexidine gel during labor modest ly reduces group B streptococcal vertical transmission. Because the method is cheap, simple and safe, it should be considered for routine use. Our results indicate that it may reduce the incidence of early onset group B streptococcal sepsis by 2-32%.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Ah Adriaanse Et a I /European Journal Of Obstetrics And Gymentioning

confidence: 99%

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Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Adriaanse¹,

Kollée²,

Muytjens³

et al. 1995

European Journal of Obstetrics & Gynecology and Reproductiv

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“…신생아 GBS 감염의 약 70%는 생후 3일 이내에 발병하며 대부분 출생 시 임신부의 산도에 존재하는 GBS를 흡 인함으로써 발생되고, 지연감염은 대개 생후 7일 이후에 발병 한다 [5,6]. GBS의 병원성은 혈청형에 따라 달라서 혈청형 II와 III의 병원성이 가장 높으며, 신생아 GBS 감염에서는 혈청형 III이 가장 흔히 분리되고 최근에는 지역에 따라 혈청형 V의 분 리율이 급격히 증가하는 추세에 있다 [7][8][9][10].…”

Section: 서 론unclassified

Colonization Rate, Serotypes, and Distributions of Macrolide-Lincosamide-Streptogramin_BResistant Types of Group B Streptococci in Pregnant Women

Choi

Jang

et al. 2009

Korean J Clin Microbiol

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“…This agent has been used successfully in developed countries for prophylaxis against newborn colonization and infection with group B streptococcus. [420][421][422][423][424][425][426] community-based evidence. A study of the impact of chlorhexidine cleansing was undertaken in Malawi at an urban hospital, at a cost of $0.10 for each maternal-infant pair treated (Table 25).…”

Section: )mentioning

confidence: 99%

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

et al. 2005

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ABSTRACT. Background. Infant and under-5 childhood mortality rates in developing countries have declined significantly in the past 2 to 3 decades. However, 2 critical indicators, maternal and newborn mortality, have hardly changed. World leaders at the United Nations Millennium Summit in September 2000 agreed on a critical goal to reduce deaths of children <5 years by two thirds, but this may be unattainable without halving newborn deaths, which now comprise 40% of all under-5 deaths. Greater emphasis on wide-scale implementation of proven, cost-effective measures is required to save women's and newborns' lives. Approximately 99% of neonatal deaths take place in developing countries, mostly in homes and communities. A comprehensive review of the evidence base for impact of interventions on neonatal health and survival in developingcountry communities has not been reported.Objective. This review of community-based antenatal, intrapartum, and postnatal intervention trials in developing countries aimed to identify (1) key behaviors and interventions for which the weight of evidence is sufficient to recommend their inclusion in communitybased neonatal care programs and (2) key gaps in knowledge and priority areas for future research and program learning.Methods. Available published and unpublished data on the impact of community-based strategies and interventions on perinatal and neonatal health status outcomes were reviewed. Evidence was summarized systematically and categorized into 4 levels of evidence based on study size, location, design, and reported impact, particularly on perinatal or neonatal mortality. The evidence was placed in the context of biological plausibility of the intervention; evidence from relevant developed-country studies; health care program experience in implementation; and recommendations from the World Health Organization and other leading agencies.Results. A paucity of community-based data was found from developing-country studies on health status impact for many interventions currently being considered for inclusion in neonatal health programs. However, review of the evidence and consideration of the broader context of knowledge, experience, and recommendations regarding these interventions enabled us to categorize them according to the strength of the evidence base and confidence regarding their inclusion now in programs. This article identifies a package of priority interventions to include in programs and formulates research priorities for advancing the state of the art in neonatal health care.Conclusions. This review emphasizes some new findings while recommending an integrated approach to safe motherhood and newborn health. The results of this study provide a foundation for policies and programs related to maternal and newborn health and emphasizes the importance of health systems research and evaluation of interventions. The review offers compelling support for using research to identify the most effective measures to save newborn lives. It also may facilitate dialogue with policy...

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Prevention of excess neonatal morbidity associated with group B streptococci by vaginal chlorhexidine disinfection during labour

Cited by 101 publications

References 20 publications

Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Colonization Rate, Serotypes, and Distributions of Macrolide-Lincosamide-Streptogramin_BResistant Types of Group B Streptococci in Pregnant Women

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

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Prevention of excess neonatal morbidity associated with group B streptococci by vaginal chlorhexidine disinfection during labour

Cited by 101 publications

References 20 publications

Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Randomized study of vaginal chlorhexidine disinfection during labor to prevent vertical transmission of group B streptococci

Colonization Rate, Serotypes, and Distributions of Macrolide-Lincosamide-StreptograminBResistant Types of Group B Streptococci in Pregnant Women

Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence

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Colonization Rate, Serotypes, and Distributions of Macrolide-Lincosamide-Streptogramin_BResistant Types of Group B Streptococci in Pregnant Women