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Presents strategies for prevention of neonatal group B streptococcal (GBS) disease. Screening for GBS carriage and selective intrapartum antibiotics; Epidemiologic risk factors; Maternal GBS vaccination; Cost-effectiveness, cost-benefit and sensitivity analyses; Impact on the population.

Opinion. Focuses on the 1997 guidelines for the prevention of early-onset group B streptococcal (GBS) disease set by the American Academy of Pediatrics (AAP) and other medical associations. Approaches for the prevention of early-onset GBS disease; Limitations of the 1992 AAP guidelines; Clarification of the appraisal of the Academy policy published in 1992.

A response by Christina Phares to a letter to the editor about her article “Epidemiology of invasive group B streptococcal disease in the United States, 1999-2005,” in the 2008;299(17):2056- 2065 issue is presented.

Interpretation: The adoption by Canadian obstetric care providers of neonatal GBS prevention practices recommended by expert groups was slow but improved significantly over time. These findings highlight the difficulties associated with achieving compliance with diverse and frequently changing recommendations. However, the associated incidence of neonatal GBS disease, which was low or declining, suggests that efforts to disseminate current GBS prevention guidelines have been moderately successful. [ABSTRACT FROM AUTHOR]

In 2002, revised guidelines for preventing perinatal group B streptococcal disease were published. In 2002, all Minnesota providers surveyed reported using a prevention policy. Most screen vaginal and rectal specimens at 34-37 weeks of gestation. The use of screening-based methods has increased dramatically since 1998. [ABSTRACT FROM AUTHOR]

Background: Group B streptococcal disease is the leading cause of neonatal sepsis in the United States. We assessed predictors of compliance with the consensus guidelines for perinatal group B streptococcus disease prevention at two Group Health Cooperative hospitals. Methods: A descriptive and cohort analysis was conducted of failure to comply with the screening-based approach to group B streptococcus prevention among singleton birth pregnancies in two Group Health Cooperative hospitals, September 1, 1996 to December 31, 1997. We studied determinants of failure to screen pregnant women for group B streptococcus at 35 to 37 weeks’ gestation and failure to deliver intrapartum antibiotic prophylaxis to Group B streptococcus-positive women. Results: Nearly 28 percent of 1969 women delivering at two Group Health Cooperative hospitals were not screened appropriately for group B streptococcus. Women who were not screened properly were more likely to be in their teens. A short length of hospital stay before delivery was the strongest predictor of the lack of administration of intrapartum antibiotic prophylaxis to infected multiparas at delivery. Group B streptococcus-positive women without pregnancy complications were less likely to receive intrapartum antibiotic prophylaxis than infected women with complications. Conclusions: The findings of this study suggest that to improve group B streptococcus disease prevention, screening efforts should focus on teenage women, and intrapartum antibiotic prophylaxis delivery efforts should be aimed at low-risk women with precipitous labor. (BIRTH 29:4 December 2002). [ABSTRACT FROM AUTHOR]