Risk of developing neonatal conjunctivitis in newborns of mothers with prolonged labour

Citation:
DR I, DG M. "Risk of developing neonatal conjunctivitis in newborns of mothers with prolonged labour." East African journal of ophthalmology. 2008;14(1).

Abstract:

Objective: To determine whether prolonged labour increased the rate of exposure
of the newborn eyes to maternal vaginal fl ora, and whether this exposure led to
higher risk of developing neonatal conjunctivitis.

Study design: cohort study

Settings: Kenyatta National hospital and Pumwani Maternity Hospital in Kenya
between August 2000 and March 2001.

Subjects: Fifty four cases of prolonged labour (PL) and 55 cases of controls
were studied. Conjunctival swabs were taken from all the newborns and high
vaginal swabs taken from every second mother. A case pair consisted of such
a pair where samples were taken from both the mother and her baby. 23 case
pairs of PL and 19 of controls were studied. This was done on average 24hrs
after delivery.

Results: Conjunctival swabs were positive in 63% of the prolonged labour (PL)
group compared to 51% of the control group (odds ratio 1.9; p-value 0.09). The
rate of transmission of vaginal fl ora to the eyes of the newborns was 57% in the
PL group compared to 40% in the controls (odds ratio 1.95; p value 0.27). The
longer, from birth, it took before taking the conjunctival swabs from the baby,
the higher was the likelihood of obtaining a positive culture (p-value 0.017 MW
test). The longer the duration of labour in the PL group, the higher the rate of
development of conjunctivitis (p-value 0.029 MW test). Staphylococcal aureus,
Staphylococcal epidermidis and E.coli were the three most common organisms
isolated in both groups.

Conclusion: Prolonged labour increased the rate of transmission of maternal
vaginal flora to the eyes of the newborns and to subsequent development of
neonatal conjunctivitis.

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