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Effect of maternal obesity on Maternal-Fetal transfer of preoperative cefazolin at cesarean section

Publication ,  Journal Article
Groff, SM; Fallatah, W; Yang, S; Murphy, J; Crutchfield, C; Marzinke, M; Kurtzberg, J; Lee, CKK; Burd, I; Azadeh, F
Published in: Journal of Pediatric Pharmacology and Therapeutics
May 1, 2017

OBJECTIVES American Congress of Obstetricians and Gynecologists recommends a single dose of antibiotic prophylaxis before all cesarean sections (C/S). This recommendation is based on pharmacokinetic studies that include only non-obese patients. We sought to evaluate 1) cefazolin plasma concentrations among obese and non-obese patients after administration of a 2-g cefazolin dose for prevention of surgical wound infections, and 2) whether cefazolin concentration in fetal circulation may be protective against pathogens that cause early onset neonatal sepsis. METHODS Maternal and fetal cefazolin plasma concentrations were compared between obese (body mass index [BMI] ≥ 30 kg/m2) and non-obese (BMI < 25 kg/m2) healthy, term pregnant women undergoing scheduled C/S. Liquid chromatographic–tandem mass spectrometric (LC-MS/MS) methods were used for quantification of total and free cefazolin concentrations in maternal blood (MB) and umbilical cord blood (UCB). RESULTS Eight women were screened and consented. There was no difference between groups in MB total and free cefazolin concentrations. All MB samples had total and free cefazolin concentrations greater than the minimum inhibitory concentration 90 (MIC90) for Group B Streptococcus (GBS), Staphylococcus aureus, and Escherichia coli. All UCB samples had total and free cefazolin concentrations greater than MIC90 for GBS and S aureus, even when administered as briefly as 18 minutes before delivery. A lower concentration of total cefazolin was detected in UCB of neonates of obese women compared to non-obese women (p > 0.05).CONCLUSIONS Administration of 2 g of cefazolin to women undergoing scheduled C/S might be an adequate prophylactic dose for surgical wound infection in both non-obese and obese patients; and cefazolin concentration in fetal circulation may be protective against GBS and S aureus.

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Published In

Journal of Pediatric Pharmacology and Therapeutics

DOI

EISSN

2331-348X

ISSN

1551-6776

Publication Date

May 1, 2017

Volume

22

Issue

3

Start / End Page

227 / 232

Related Subject Headings

  • 3214 Pharmacology and pharmaceutical sciences
  • 3213 Paediatrics
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Groff, S. M., Fallatah, W., Yang, S., Murphy, J., Crutchfield, C., Marzinke, M., … Azadeh, F. (2017). Effect of maternal obesity on Maternal-Fetal transfer of preoperative cefazolin at cesarean section. Journal of Pediatric Pharmacology and Therapeutics, 22(3), 227–232. https://doi.org/10.5863/1551-6776-22.3.227
Groff, S. M., W. Fallatah, S. Yang, J. Murphy, C. Crutchfield, M. Marzinke, J. Kurtzberg, C. K. K. Lee, I. Burd, and F. Azadeh. “Effect of maternal obesity on Maternal-Fetal transfer of preoperative cefazolin at cesarean section.” Journal of Pediatric Pharmacology and Therapeutics 22, no. 3 (May 1, 2017): 227–32. https://doi.org/10.5863/1551-6776-22.3.227.
Groff SM, Fallatah W, Yang S, Murphy J, Crutchfield C, Marzinke M, et al. Effect of maternal obesity on Maternal-Fetal transfer of preoperative cefazolin at cesarean section. Journal of Pediatric Pharmacology and Therapeutics. 2017 May 1;22(3):227–32.
Groff, S. M., et al. “Effect of maternal obesity on Maternal-Fetal transfer of preoperative cefazolin at cesarean section.” Journal of Pediatric Pharmacology and Therapeutics, vol. 22, no. 3, May 2017, pp. 227–32. Scopus, doi:10.5863/1551-6776-22.3.227.
Groff SM, Fallatah W, Yang S, Murphy J, Crutchfield C, Marzinke M, Kurtzberg J, Lee CKK, Burd I, Azadeh F. Effect of maternal obesity on Maternal-Fetal transfer of preoperative cefazolin at cesarean section. Journal of Pediatric Pharmacology and Therapeutics. 2017 May 1;22(3):227–232.

Published In

Journal of Pediatric Pharmacology and Therapeutics

DOI

EISSN

2331-348X

ISSN

1551-6776

Publication Date

May 1, 2017

Volume

22

Issue

3

Start / End Page

227 / 232

Related Subject Headings

  • 3214 Pharmacology and pharmaceutical sciences
  • 3213 Paediatrics