Risk Of Newborns Developing Neonatal Conjunctivitis From Mothers With Prolonged Labour

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.