Screening pregnant women for group B streptococcus infection between 30 and 32 weeks of pregnancy in a population at high risk for premature birth

Int J Gynaecol Obstet. 2013 Jul;122(1):9-12. doi: 10.1016/j.ijgo.2013.01.027. Epub 2013 Apr 8.

Abstract

Objective: To assess the benefits of a chemoprophylaxis program based on screening women for group B streptococcus (GBS) infection between 30 and 32 weeks of pregnancy in a population with a high rate of premature births.

Methods: From 1995 to 2011, 24 950 women were screened for GBS infection between 30 and 32 weeks of pregnancy at Markusovszky Teaching Hospital, Szombathely, Hungary. Those who tested positive, and those who tested negative but were at risk of infecting their newborns, underwent intrapartum prophylaxis. Neonatal outcomes were compared with those of a historical cohort that underwent no screening or treatment, and with those published in CDC/ACOG guidelines recommending screening closer to term.

Results: There were 63 infected newborns (0.2%) in the study cohort, and 1 of 8 with sepsis died. There were 149 infected newborns (0.7%) in the historical cohort, and 29 of 31 with sepsis died.

Conclusion: Screening women early in a population with a high rate of premature births may simplify preterm labor management. It results, however, in a higher incidence of early onset neonatal GBS disease than when screening is done closer to term.

MeSH terms

  • Chemoprevention / methods
  • Female
  • Hospitals, Teaching
  • Humans
  • Hungary
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Mass Screening / methods
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Complications, Infectious / diagnosis*
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / microbiology
  • Pregnancy Outcome
  • Premature Birth / microbiology
  • Prospective Studies
  • Risk Factors
  • Streptococcal Infections / complications
  • Streptococcal Infections / diagnosis*
  • Streptococcal Infections / drug therapy
  • Streptococcus agalactiae / isolation & purification*
  • Time Factors