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Obstet Gynecol. 2012 Apr;119(4):822-9. doi: 10.1097/AOG.0b013e31824b1461.

Cost and effectiveness of intrapartum group B streptococcus polymerase chain reaction screening for term deliveries.

Author information

1
Groupe Hospitalier Paris-Saint-Joseph, Paris, France. nelhelali@hpsj.fr

Abstract

OBJECTIVE:

To estimate the cost and consequences of intrapartum polymerase chain reaction (PCR) screening on early-onset group B streptococcal (GBS) disease compared with the antenatal lower vagina culture screening recommended in France.

METHODS:

This was a single-institution study comparing the intrapartum PCR screening strategy implemented in 2010 with antenatal culture strategy in place in 2009. Early-onset GBS disease in newborns was monitored exhaustively. We estimated direct costs, including screening test costs and hospital costs, for deliveries of healthy newborns compared with those infected with GBS. Costs in 2009 and 2010 were compared on an intention-to-treat basis.

RESULTS:

Term deliveries were 2,761 and 2,814 in 2009 and 2010, respectively. Among the screened mothers, the vaginal GBS colonization rate was 11.7% based on antenatal GBS culture screening in 2009 compared with 16.7% in 2010 using the intrapartum PCR testing. The overall probabilities of neonatal GBS disease were 0.9% compared with 0.5%, and the average total cost per delivery was $1,759±1,209 in 2009 compared with $1,754±842 in 2010 (P=.9) in antenatal and intrapartum screening strategies, respectively. The number and severity of cases of early-onset GBS disease and the resulting hospital costs were higher in 2009.

CONCLUSION:

Polymerase chain reaction intrapartum screening strategy was cost-neutral when compared with the 2009 antenatal lower vagina culture screening, with a significant decrease in early-onset GBS disease.

PMID:
22433346
DOI:
10.1097/AOG.0b013e31824b1461
[Indexed for MEDLINE]

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