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Obstet Gynecol. 2019 Feb;133(2):276-281. doi: 10.1097/AOG.0000000000003057.

Point-of-Care Intrapartum Group B Streptococcus Molecular Screening: Effectiveness and Costs.

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Service de Microbiologie Clinique, Groupe Hospitalier Paris Saint-Joseph, France-EA4043 Unité Bactéries Pathogènes et Santé, Université Paris-Sud Saclay, Chatenay-Malabry, Service de Néonatologie, Groupe Hospitalier Paris Saint-Joseph, Service de Gynécologie Obstétrique, Groupe Hospitalier Paris Saint-Joseph, France - UMR1153, Obstetrical, neonatal and pediatric epidemiology research team (EPOPé) - DHU Risk in pregnancy - Paris Descartes University, AP-HP Unité de Recherche Clinique en Economie de la Santé d'Ile-de-France, Hôpital de l'Hôtel Dieu, ECEVE, UMR1123, Université Paris Est Créteil, Paris France.



To assess outcomes and costs associated with around-the-clock point-of-care intrapartum group B streptococcus (GBS) polymerase chain reaction (PCR) screening.


Intrapartum PCR screening was implemented in 2010. Intrapartum PCR was compared with antenatal culture screening in an uncontrolled, single institution, preintervention and postintervention study. The study periods included 4 years before and 6 years after the intervention, commencing in 2006 and concluding in 2015. The primary outcome measure was rate of early-onset neonatal GBS disease. Secondary outcomes included length of stay, days of antibiotics, and costs.


During the 4 years of antenatal culture screening, 11,226 deliveries were recorded compared with 18,835 in the 6 years of intrapartum GBS PCR screening, corresponding to 11,818 and 18,980 live births, respectively. During the antenatal culture period, 3.8% of term deliveries did not undergo GBS testing compared with 0.1% during the intrapartum PCR period (P<.001). Between the two periods, the rate of proven early-onset GBS disease cases decreased from 1.01/1,000 to 0.21/1,000 (P=.026) and probable early-onset GBS disease cases from 2.8/1,000 to 0.73/1,000 (P<.001); the risk ratio for both was 0.25, 95% CI (0.14-0.43). Total days of hospital and antibiotic therapy for early-onset GBS disease declined by 64% and 60%, respectively, with no significant difference for average length of stay or antibiotic duration preintervention and postintervention. The yearly cost of delivery and treatment of newborns with GBS infection was reduced from $41,875±6,823 to $11,945±10,303 (P<.001). The estimated extra cost to avoid one early-onset GBS disease was $5,819.


Point-of-care intrapartum GBS PCR screening was associated with a significant decrease in the rate of early-onset GBS disease and antibiotic use in newborns. The additional PCR costs were offset in part by the reduction in early-onset GBS disease treatment costs.

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