GBS screening on L&D improves detection and treatment rates

  • Obstet Gynecol

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Group B streptococcus (GBS) testing with PCR in Labor and Delivery (L&D) improves detection and treatment rates.

Why this matters

  • Prevention of early-onset GBS disease in newborns currently relies on culture testing at 35-37 weeks gestation and intrapartum antibiotics.
  • Molecular screening allows for point-of-care testing.

Key results

  • Positive screening rates were higher with PCR (14.5% vs 12.2%; P<.001>
  • No difference in women receiving antibiotics with different modes of detection.
  • More women underwent GBS testing during the intervention (99.9% vs 96.2%; P<.001>
  • In both periods, approximately 50% of treated women received at least 2 doses of penicillin G.
  • Early-onset GBS disease declined with the intervention (64% decline vs 60% decline).
  • Cost decreased with PCR testing (average cost of delivery $2691 vs $2381); the additional costs of the PCR test were offset by decrease of early-onset GBS disease treatment costs.

Study design

  • Single-institution, before/after uncontrolled study.
  • Intervention was intrapartum GBS screening using PCR for term deliveries, implemented in 2010.
  • Outcomes studied before intervention (GBS culture at 35-37 weeks of gestation; n=11,226) and after intervention (n=18,835) compared.
  • Funding: None disclosed.

Limitations

  • No control group.
  • Results may not be generalizable to other populations.