Study Finds Evidence Prenatal Screening is Most Effective Strategy to Prevent Newborn Strep B Infections
The Centers for Disease Control and Prevention (CDC) today released data indicating routine screening for group B streptococcus late in pregnancy is the most effective way to prevent transmission of the bacteria from mother to child during delivery. The data were published in the July 25, 2002 issue of the New England Journal of Medicine.
"Group B streptococcal disease remains a leading infectious cause of illness and death among newborns in the United States, resulting in approximately 1,600 illnesses and 80 deaths each year," said CDC Director Dr. Julie Gerberding. "It's hoped that the results of this study will lead to more doctors and other health care providers routinely screening women late in pregnancy for this bacteria, which can lead to long-term developmental disabilities, such as mental retardation, or hearing or vision loss in children who survive an infection."
Guidelines issued in 1996 to prevent transmission of the bacteria from mother to newborn recommend that health care providers use one of two methods -
offer antibiotics to women with clinical risk factors for disease transmission at the time of labor (fever, prolonged interval between rupture of the membranes and delivery, or preterm delivery)
screen women for carriage of group B streptococci between week 35 and 37 of their pregnancy and then to offer antibiotics during delivery to those who have the bacteria.
The data released today show that the prenatal screening method was more than 50 percent more effective in preventing transmission than the clinical risk factor method.
"The main reason for the benefit of routine screening over the risk-based approach is that prenatal screening identifies silent carriers who can pass on the infection to newborns even when no clinical risk factors are present during labor," said Dr. Stephanie Schrag, a CDC epidemiologist and lead author of the study. "This is the first time we have a large multi-state study comparing the two methods and we believe that this study will soon lead to new guidelines that will call for routine screening late in pregnancy."
CDC, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics are all updating their previous recommendations in light of these new data. CDC's guidelines will be published in Morbidity and Mortality Weekly Report in August. For more information on group B streptococcal disease go to http://www.cdc.gov/ncidod/dbmd/gbs/.
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