Estreptococos do grupo B e partos prematuros: uma revisão narrativa
DOI:
https://doi.org/10.53843/bms.v8i12.450Palavras-chave:
Estreptococos do Grupo B, Prematuridade, AntibioticoprofilaxiaResumo
Introdução: Nascimentos prematuros são aqueles que ocorrem antes das 37 semanas de idade gestacional. Uma condição clínica que permanece problemática para a obstetrícia, principalmente pela alta mortalidade neonatal que causa. Embora a maioria das crianças sobreviva, elas correm o risco de maiores danos ao desenvolvimento neurológico e complicações respiratórias e gastrointestinais. Microrganismos, como Streptococcal agalactiae (Grupo B Streptococcal - GBS), têm sido associados à prematuridade. Esta revisão abrangente tem como objetivo apresentar dados sobre a associação entre GBS e prematuridade.
Métodos: Utilizando as palavras-chave Group B Streptococcal, prematurity e Intrapartum antibiotic therapy, foram pesquisados artigos nas seguintes bases de dados: PubMed, Cochrane database of Systematic Reviews, Cochrane Central Register of Controlled Trials e Lilacs/Scielo. Foram considerados os trabalhos mais relevantes aqueles publicados sobre o tema no período de 1º de janeiro de 1973 a 31 de dezembro de 2021 disponíveis nas bases de dados consultadas.
Resultados: A ruptura prematura das membranas ovulares (RPM) ocorre em 1% a 3% das gestações, sendo uma importante causa de morbimortalidade perinatal e estando associada a 30-40% dos partos prematuros. A infecção causada pelo estreptococo do grupo B, tem sido apontada como importante fator de risco de parto prematuro, principalmente em pacientes com amniorrexe prematura das membranas ovulares.
Discussão: Medidas preventivas de profilaxia para gestantes, como medicação intraparto, para reduzir a transmissão vertical de doenças invasivas por GBS resultaram em diminuição significativa da doença precoce do recém-nascido pelo patógeno. Além disso, a penicilina foi e continua sendo o antimicrobiano de escolha devido ao fato de possuir um espectro microbicida mais estreito que a ampicilina, reduzindo assim a probabilidade de desenvolvimento de resistência bacteriana.
Conclusão: O GBS tem sido associado ao aumento do risco de parto prematuro devido à ruptura prematura da membrana. Além disso, a antibioticoterapia para infecção vaginal por bactérias reduziu o parto prematuro com baixo peso em algumas populações.
Métricas
Referências
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