title: Group B Streptococcus exposure and self-limited respiratory distress in late preterm and term neonates.
abstract: BACKGROUND
  Self-limited respiratory distress is a common neonatal respiratory morbidity for which effective treatments are lacking. Supportive care with non-invasive respiratory support is the norm. Animal models suggest that intrapartum exposure to group B Streptococcus (GBS) may cause mild pulmonary hypertension in the neonate, resulting in self-resolving respiratory distress. Treatments for pulmonary hypertension are currently not provided to neonates with self-limited respiratory distress empirically.
  
  
  OBJECTIVE
  This study examines the hypothesis that the incidence and severity of self-limited respiratory distress are altered by intrapartum exposure to GBS and antibiotic prophylaxis (IAP) in a human population.
  
  
  METHODS
  This is a 10-year single-center cohort study of retrospective data of late preterm and term neonates diagnosed with self-limited respiratory distress. Multiple logistic models were fitted to examine associations between exposure to GBS and IAP, and markers of self-limited respiratory distress severity. Additional linear regression models were fitted to examine the association between exposure to GBS and IAP, and duration of respiratory support for self-limited respiratory distress. Finally, crude and gestational age-adjusted incidence of self-limited respiratory distress among GBS-exposed and -unexposed infants, as well as the odds of self-limited respiratory distress based on GBS exposure were calculated.
  
  
  RESULTS
  584 neonates met study criteria. Neither GBS exposure nor IAP exposure was associated with severity of self-limited respiratory distress in multiple models. Crude and adjusted incidence of self-limited respiratory distress among neonates did not differ by GBS exposure history.
  
  
  CONCLUSIONS
  Although animal studies indicate that GBS-mediated pulmonary hypertension may contribute to self-limited respiratory distress, neither exposure to GBS nor IAP was associated with an increased severity or incidence of self-limited respiratory distress in our human study population. Treatments for pulmonary hypertension are unlikely to speed symptom resolution for patients with self-limited respiratory distress.
authors.affiliation: Division of Newborn Medicine, Kravis Children's Hospital, Mount Sinai Medical Center, New York, N.Y., USA.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Stroustrup
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Weintraub
authors.forename: Claudia T
authors.initials: CT
authors.lastname: Cadet
authors.forename: Roxane
authors.initials: R
authors.lastname: Perez
authors.forename: Elissa
authors.initials: E
authors.lastname: DeLorenzo
authors.forename: Ian R
authors.initials: IR
authors.lastname: Holzman
mesh_terms: D019072:Antibiotic Prophylaxis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D016015:Logistic Models; D011247:Pregnancy; D012131:Respiratory Insufficiency / Q000382:microbiology*; D012189:Retrospective Studies; D013290:Streptococcal Infections / Q000382:microbiology / Q000503:physiopathology*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*