Impact of maternal group B streptococcal screening on pediatric management in full-term newborns

Academic Article

Abstract

  • Background: The American Academy of Pediatrics strategy to prevent early-onset neonatal sepsis with group B streptococcus (GBS) relies on maternal antepartum GBS cultures, while the American College of Obstetrics and Gynecology strategy does not. Objective: To evaluate the impact of the 2 strategies on the care of asymptomatic full-term newborns. Design/Setting: Self-administered survey mailed to a national random sample of US pediatricians who were members of the American Academy of Pediatrics. Participants: A total of 461 members of the American Academy of Pediatrics who routinely care for newborns. Main Outcome Measure: Self-report of diagnostic and treatment strategies for asymptomatic full-term newborns who were born under different clinical scenarios. Maternal risk factors, antepartum maternal GBS screening status, and maternal treatment with intrapartum antibiotics were varied across the scenarios. Results: Pediatricians treating asymptomatic full-term newborns born to risk factor- negative mothers reported ordering tests (63.3% in GBS-positive cases vs 6.7% with GBS unknown; P=.001) and antibiotics (21.5% in GBS-positive cases vs 0.9% with GBS unknown; P=.001) more frequently when presented with a positive maternal GBS screening result. Maternal intrapartum treatment had little impact on pediatric practice when risk factors were absent. In risk factor- positive mothers, pediatricians reported an increase in their antibiotic usage in response to a positive maternal GBS screen (61.8% in GBS-positive cases vs 36.9% with GBS unknown; P=.001). In risk factor-positive mothers with unknown results of GBS screening, use of intrapartum antibiotics increased the number of pediatricians who reported that they would prescribe antibiotic therapy. Conclusions: Obstetrical strategies to decrease the risk of neonatal GBS sepsis increase pediatric services provided to full-term healthy newborns. This increase in services by pediatric practices is likely to be greater with the screening-based strategy recommended by the American Academy of Pediatrics.
  • Authors

    Published In

  • JAMA Pediatrics  Journal
  • Digital Object Identifier (doi)

    Author List

  • Peralta-Carcelen M; Fargason CA; Cliver SP; Cutter GR; Gigante J; Goldenberg RL
  • Start Page

  • 802
  • End Page

  • 808
  • Volume

  • 150
  • Issue

  • 8