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ABSTRACT Objective To determine the cost effectiveness of strategies for preventing neonatal infection with group B streptococci and other bacteria in the UK and the value of further information from research. Design Use of a decision model to compare the cost effectiveness of prenatal testing for group B streptococcal infection (by polymerase chain reaction or culture), prepartum antibiotic treatment (intravenous penicillin or oral erythromycin), and vaccination during pregnancy (not yet available) for serious bacterial infection in early infancy across 12 maternal risk groups. Model parameters were estimated using multi-parameter evidence synthesis to incorporate all relevant data inputs. Data sources 32 systematic reviews were conducted: 14 integrated results from published studies, 24 involved analyses of primary datasets, and five included expert opinion. Main outcomes measures Healthcare costs per quality adjusted life year (QALY) gained. Results Current best practice (to treat only high risk women without prior testing for infection) and universal testing by culture or polymerase chain reaction were not cost effective options. Immediate extension of current best practice to treat all women with preterm and high risk term deliveries without testing (11% treated) would result in substantial net benefits. Currently, addition of culture testing for low risk term women, while treating all preterm and high risk term women, would be the most cost effective option (21% treated). If available in the future, vaccination combined with treating all preterm and high risk term women and no testing for low risk women would probably be marginally more cost effective and would limit antibiotic exposure to 11% of women. The value of information is highest (£67m) if vaccination is included as an option. Conclusions Extension of current best practice to treat all women with preterm and high risk term deliveries is readily achievable and would be beneficial. The choice between a [ABSTRACT FROM AUTHOR]

Provides information on a study which assessed the cost effectiveness of universal antenatal HIV screening compared with selective screening in Great Britain. Methodology; Net benefit of antenatal diagnosis of HIV; Results and conclusion.

Describes the epidemiology of vertically transmitted HIV infection in the British Isles. Trends in HIV infection and vertical transmission rate; Significance of antenatal testing on counselling women against breast feeding; Importance of antenatal testing on preventing infection.

Presents information on a study conducted to describe the epidemiology of human immunodeficiency virus-1 (HIV-1) infection in pregnant women in the United Kingdom. Investigation of time trends in the prevalence of HIV-1 infection in mothers of newborn babies; Results obtained; Conclusions drawn from results.

Presents information on a study which interpreted time trends in vertical transmission rates for HIV using data from national obstetric and paediatric surveillance registers in British Isles. Population studied; Statistical methods; Results and conclusion.

Presents a study which sought to measure the uptake of antenatal human immunodeficiency virus (HIV) testing, in addition to determining its relation to risk of HIV and to screening practices. Subjects used for the study; Methodology of study; Results obtained; Discussion of results.

Investigates the prevalence of human T cell leukemia/lymphoma virus type I among patients attending an antenatal clinic in London, England. Assessment on the enzyme linked immunosorbent assay (ELISA) of the patients; Examination on the serum samples associated in ELISA; Interpretation of the seropositivity inhibited in the samples.

Examines the prevalence of toxoplasma immunoglobulin G among pregnant women according to country of birth and ethnic groups in west London, England. Infection of toxoplasmosis before immigration to London; Possibility of diet as a cause of toxoplasmosis; Differences on the seroprevalence of toxoplasma in different countries.