NEW YORK (Reuters Health) – Compared with antenatal vaginal cultures, intrapartum PCR screening for maternal group B streptococcal colonization reduces the rate of neonatal GBS disease, a French study has shown.
Furthermore, “When the costs of screening and antibiotic prophylaxis were included, we found that intrapartum PCR was cost-neutral compared with antenatal vagina culture screening,” note the authors of the report in the April edition of Obstetrics & Gynecology.
Dr. Najoua El Helali, with Groupe Hospitalier Paris-Saint-Joseph in Paris, and colleagues explain that previous studies have shown that 65% of neonates infected with GBS were born to mothers who tested negative by antenatal culture screening. This prompted the group to institute the use of intrapartum PCR screening for GBS colonization.
For the current study, the team examined the cost and consequences of intrapartum PCR screening, which was started in 2010, compared with the antenatal culture strategy in place in 2009. They found that, among term deliveries, the rate of vaginal GBS colonization was 16.7% in the 2010 cohort versus 11.7% in the 2009 group, and similar percentages received antibiotic prophylaxis.
The overall probability of GBS infection in newborns in the two cohorts was 0.5% versus 0.9%, according to the report. “The number and severity of cases of early-onset GBS disease and the resulting hospital costs were higher in 2009,” according to the report.
The authors summed the costs of screening, prophylaxis, delivery, and treatment of neonatal GBS infection and arrived at an average total cost per delivery of $1754 in the PCR group compared with $1759 in the culture group.
“This study demonstrated the feasibility of intrapartum PCR screening, which resulted in a significant decrease in probability of GBS infection in newborns with fewer severe cases and the same average costs compared with the antenatal lower vagina culture screening strategy recommended in France,” Dr. El Helali and colleagues conclude.
They add, “A key success factor was the empowerment of the midwives in the management of PCR processing.”
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