Publication: Gebeliğinde idrar yolu enfeksiyonu geçiren annelerin bebeklerinde erken sepsis görülme sıklığı
Abstract
Amaç: Çalışma, gebeliğinde idrar yolu enfeksiyonu geçiren annelerin bebeklerinde erken sepsis görülme sıklığını saptamak amacıyla yapıldı.Gereç ve Yöntem: Bu çalışma, T.C. SB Marmara Üniversitesi Pendik EAH’nde 5 Ocak 2020 – 5 Mayıs 2020 tarihlerinde doğum yapan, idrar yolu enfeksiyonu olan ve olmayan bütün gebeler ve bebeklerinden oluşmuş prospektif kohort çalışmadır. Erken yenidoğan sepsisi olma olasılığı idrar yolu enfeksiyonu olmayan annelerde 10 binde 8, gebeliğinde idrar yolu enfeksiyonu olan annelerin bebeklerinde yüzde 8 olarak alındığında, alfa hata 0,05, güç %80 olarak belirlendiğinde en az 86 kişiye ulaşılması gerektiği hesaplanmıştır.Bulgular: Araştırmaya dahil edilen toplam gebe ve bebeklerinin sayısı 417, erken sepsis taraması yapılan bebek sayısı 167’dir. Gebelerin yaş ortalaması 28,9±5,8, bebeklerin doğum haftaları ortalaması 38,7±1,4'tür. Annelerin %38,1’inde gebelik öncesinde İYE hikayesi olup, bu gebeliğinde İYE semptomu olanların oranı %44,6'dır. Gebelerin %30,2’sinden idrar kültürü alınmış, kültüründe üreme saptananların oranı %5 bulunmuştur. Gebelik öncesinde İYE hikayesi olanların bu gebeliklerinde İYE olmaları daha sık olup, bu fark istatistiksel olarak anlamlı bulunmuştur. Erken sepsis taraması yapılan bebeklerin sadece iki bebekte sepsis şüphesi saptanmıştır. Asemptomatik olup, sepsis şüphesi nedeniyle intravenöz antibiyotik başlanan bu iki bebeğin kan kültüründe üreme saptanmamış ve antibiyotik tedavisi beşinci günde sonlandırılmıştır.Sonuçlar: Gebeliğinde İYE geçirme hikayesi olan ve anne yanında izlenen 35. gebelik haftası ve üzerindeki bebeklerde klinik veya kültür pozitif sepsis saptanmamıştır. Bu nedenle son trimesterde geçirilen İYE’nun sepsis gelişiminde ek bir risk faktörü oluşturmadığı düşünülmüştür.
Aim: The study was conducted to determine the prevalence of early-onset neonatal sepsis (EONS) in babies of mothers who had urinary tract infections (UTI) during pregnancy.Materials and Methods: This prospective cohort study consisting of mother-baby dyads was conducted at Marmara University Training and Research Hospital between January 5 and May 5, 2020. We calculated that at least 86 participants were needed to achieve 80% power (α = 0.05) to detect significant associations with error.Results: The total number of mother-baby dyad included in the study was 417, and the number of babies who were screened for EONS was 167. The mean age of the mothers was 28.9±5.8, while the mean gestational week was 38.7±1.4. 38.1% of the mothers had a history of UTI before pregnancy. The rate of UTI symptoms in this pregnancy was 44.6% and the rate of urine culture positivity was 5%. In those with a history of UTI before pregnancy, having UTI was more common in this pregnancy, and this difference was found to be statistically significant. There were two newborns with suspected sepsis. No growth was detected in their blood culture and antibiotic treatment was terminated on the fifth day.Conclusion: No possible or proven neonatal sepsis was found in babies who were born to mothers with a history of UTI in pregnancy. Therefore, it was thought that UTI in the last trimester did not constitute an additional risk factor in the development of EONS.
Aim: The study was conducted to determine the prevalence of early-onset neonatal sepsis (EONS) in babies of mothers who had urinary tract infections (UTI) during pregnancy.Materials and Methods: This prospective cohort study consisting of mother-baby dyads was conducted at Marmara University Training and Research Hospital between January 5 and May 5, 2020. We calculated that at least 86 participants were needed to achieve 80% power (α = 0.05) to detect significant associations with error.Results: The total number of mother-baby dyad included in the study was 417, and the number of babies who were screened for EONS was 167. The mean age of the mothers was 28.9±5.8, while the mean gestational week was 38.7±1.4. 38.1% of the mothers had a history of UTI before pregnancy. The rate of UTI symptoms in this pregnancy was 44.6% and the rate of urine culture positivity was 5%. In those with a history of UTI before pregnancy, having UTI was more common in this pregnancy, and this difference was found to be statistically significant. There were two newborns with suspected sepsis. No growth was detected in their blood culture and antibiotic treatment was terminated on the fifth day.Conclusion: No possible or proven neonatal sepsis was found in babies who were born to mothers with a history of UTI in pregnancy. Therefore, it was thought that UTI in the last trimester did not constitute an additional risk factor in the development of EONS.