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Objective <p>To determine whether post-birth ampicillin levels in umbilical cord blood are affected by prenatal ampicillin administration dose.</p> Methods <p>From pregnant women with Group B streptococcus (GBS) colonization, 159 cord blood samples were prospectively collected at delivery and analyzed using liquid chromatography–mass spectrometry.</p> Results <p>Pharmacokinetic analysis revealed that maternal body mass index (BMI) negatively correlated with ampicillin levels of umbilical cord blood in pregnant women receiving at least 1 dose of 1-g ampicillin after a 2-g ampicillin loading dose (<i>P</i> = 0.005) and those who only received 2-g ampicillin(<i>P</i> = 0.044). The prophylaxis duration had no independent effect. Crucially, all samples exceeded bactericidal thresholds, even in women receiving only a single 2-g loading dose due to rapid delivery. The minimal concentration of ampicillin was 1.13 μg/mL in this cohort.</p> Conclusion <p>The current intrapartum ampicillin regimens remain effective for preventing neonatal GBS infection regardless of maternal BMI or labor duration.</p>

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Influence of the dose and duration of intrapartum antibiotic prophylaxis on umbilical cord blood ampicillin levels

  • 期刊论文

  • 发表日期：

    2026年4月20日

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  • Tzu-Hsiang Kao,
  • Ang Sau Xiong,
  • Sung Fa Huang,
  • Liang-Kai Wang,
  • Chen-Yu Chen,
  • Chie-Pein Chen

摘要

Objective

To determine whether post-birth ampicillin levels in umbilical cord blood are affected by prenatal ampicillin administration dose.

Methods

From pregnant women with Group B streptococcus (GBS) colonization, 159 cord blood samples were prospectively collected at delivery and analyzed using liquid chromatography–mass spectrometry.

Results

Pharmacokinetic analysis revealed that maternal body mass index (BMI) negatively correlated with ampicillin levels of umbilical cord blood in pregnant women receiving at least 1 dose of 1-g ampicillin after a 2-g ampicillin loading dose (P = 0.005) and those who only received 2-g ampicillin(P = 0.044). The prophylaxis duration had no independent effect. Crucially, all samples exceeded bactericidal thresholds, even in women receiving only a single 2-g loading dose due to rapid delivery. The minimal concentration of ampicillin was 1.13 μg/mL in this cohort.

Conclusion

The current intrapartum ampicillin regimens remain effective for preventing neonatal GBS infection regardless of maternal BMI or labor duration.