Early neonatal sepsis: risk factors, with emphasis on streptococcus agalactiae infections among pregnant women

Objective: Determine the prevalence of vaginal and rectal colonization by Streptococcus agalactiae (SGB) and determine risk factors for the development of early neonatal sepsis. Methods: The study considered pregnant women seeking obstetric services in a maternity school in Rio de Janeiro State, Brazil. The study was divided into two phases: i) material collection from the vaginal and anorectal regions using swabs, to be cultured on agar-blood plates, to determine the prevalence of SGB among 60 patients after the 28th week of pregnancy. Confirmation was performed using the Gram and Catalase test; ii) analysis of the risk factors for developing early neonatal sepsis using a case/control type study involving 15 cases and two controls for each case, resulting in a total sample size of 45 patients. The variables analyzed were: maternal age, gestational age, neonatal birth weight, and the occurrence of a urinary tract infection during gestation. Results: The risk factors for the development of early neonatal sepsis were found to be: prematurity (OR 2.61; p < 0.001), low birth weight (OR 2; p < 0.001), and the presence of a urinary infection during gestation (OR 2.66; p < 0.001). The prevalence of colonization by SGB was 40%. In 25% of the cases, the pregnant women reported symptoms of urinary tract infections: dysuria (55%), pollakiuria (50%), urinary urgency (45%), and vaginal discharge (40%). In 8% of the cases, the neonates evolved towards early sepsis, and of those, one progressed to death (4.16%). Conclusions: In light of the prevalence of SGB infections observed in our study, we confirm the necessity of routine culture exams for all pregnant women. Prematurity and low birth weight emerged as risk factors associated with early neonatal sepsis.