Prevention of Early-Onset Neonatal GBS Disease

One of 2 screening methods is currently recommended for the prevention of neonatal group B streptococcal (GBS) infections: risk-based or a screening (by culture) approach. Investigators from the Centers for Disease Control (CDC) reviewed a random sample of 5,144 live births from a total of 629,912 infants born in their surveillance area between 1998 and 1999. The screened group of mothers included 2,628 women; the risk-based group 2,515. Active surveillance for early-onset GBS infection identified 312 cases (.5/1,000 live births) whose infants developed early-onset GBS disease. Sixty-two percent (195 of 312) of the women were not at high risk for transmission of GBS infection to their infants. Although overall 98.1% of the women had at least 1 prenatal visit, the risk-based group was less likely to have had prenatal care (P<.001) and more likely to deliver prematurely (P<.001). The screening-based group was more likely to have had GBS bacteriuria during pregnancy (P=.003) and a previous infant with GBS disease (P=.01). Univariate analysis showed that the screening-based group was at a lower risk to have an infant with early-onset GBS disease than the risk-based …