Intrapartum test for detection of Group B Streptococcus colonization during labor. (17th December 2018)

• Record Type: Journal Article
• Authors: Picchiassi, Elena; Coata, Giuliana; Babucci, Giulia; Giardina, Irene; Summa, Valentina; Tarquini, Federica; Centra, Michela; Bini, Vittorio; Cappuccini, Benito; Di Renzo, Gian Carlo
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 31:Number 24(2018)
• Page Start: 3293
• Page End: 3300
• Publication Date: 2018-12-17
• Subjects: Antepartum Group B Streptococcus (GBS) screening culture -- GBS -- GBS Early Onset Disease (EOD) -- intrapartum antibiotic prophylaxis (IAP) -- nucleic acid amplification test (NAAT); Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2017.1369041
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Purpose: The purpose of this study was to evaluate the potential improvement of introducing an intrapartum test for the detection of Group B Streptococcus (GBS) during labor and to estimate its cost-effectiveness versus antepartum GBS screening culture. Materials and methods: Three hundred and thirteen women at beginning of labor, with unknown GBS status or with antepartum GBS screening culture were enrolled. A vaginal–rectal specimen was collected from each woman for GBS detection by real-time PCR. Results of intrapartum test and antepartum GBS screening culture were compared. Results: Antepartum culture results did not always reflect the intrapartum maternal GBS colonization status since in 15.1% of the cases it was not concordant with intrapartum test. However, selecting only women, who underwent antepartum culture and intrapartum test at the same time, the percentage of concordance was 96.6%. Based on intrapartum test results, 74.9% of the total number of intrapartum antibiotic prophylaxis (IAP) was administered uselessly, while 1.9% of women did not receive IAP although they were positive to intrapartum test. Intrapartum test resulted less cost-effective than antepartum culture but it became more cost-effective at a cost threshold of about 16.00 €. Conclusions: The clinical introduction of intrapartum test could be a valuable mean for identification of GBS colonization during labor, allowing an appropriate management of mothers and neonates with consequent benefit for their health and with limited costs for Healthcare System.