[Induced labor: a risk factor of maternal-fetal contamination during delivery?]

Abstract

Objective: This prospective study was conducted to determine the prevalence of maternal-fetal contamination at delivery in order to evaluate the factors of risk, particularly whether inducing delivery could be of additional help in selecting portage in mothers and infants.

Methods: Over a period of 4 months, samples were obtained from 360 mother/infant pairs. Vaginal sample at the beginning of labour, gastric sample from the infant at birth.

Results: Positive samples were obtained from 58 women (16.1%) and from 40 infants (11%). Streptococcus B was largely predominant (60%). The rate of maternal and neonatal carriers was significantly higher in pairs for which labour had been induced (n = 92) than in those with spontaneous labour (n = 268). Taking into account solely the classical factors of risk (opening of the membranes > 12 h, T > or = 38 degrees C, prolonged labour, premature delivery, premature rupture of the membranes), only selected 37% of the infant carriers (1 criteria or more); when induced labour was added as a criteria of risk, 68.4% of the infant carriers were identified. Streptococcus B was the cause of 2 neonatal infections in this series. None of the classic risk factors was observed in either of these cases but labour had been induced in both.

Conclusion: The fact that labour is induced appears to be an additional factor of risk of maternal and fetal colonization. Routine screening at 12 and 24 hours before inducing labour could lead to the discovery of a large number of maternal colonizations and would allow prophylaxic antibiotics to be prescribed during labour. This protocol should be evaluated in a randomized prospective study involving a large number of cases in order to identify the beneficial effect in terms of neonatal morbidity and mortality.