Perinatology.  2019 Dec;30(4):200-207. 10.14734/PN.2019.30.4.200.

Evaluation of the Early Onset Neonatal Sepsis according to Two Antenatal Group B Streptococcus Screening Methods: Risk-Based versus Universal Screening

• Hong JY
• Kim SH
• Kim SM
• Yee CA
• Choi SJ
• Oh SY
• Roh CR

• KMID: 2468540
• DOI: http://doi.org/10.14734/PN.2019.30.4.200

Abstract

OBJECTIVE
The standard antenatal screening method for Group B Streptococcus (GBS) has not been established yet. Therefore, many practitioners in South Korea offer GBS screening to all pregnant women without solid clinical evidence. The aim of this study was to compare the rates of early onset neonatal sepsis (EONS) according to two different antenatal GBS screening methods - risk-based versus universal screening.
METHODS
This is a retrospective cohort study from January 2014 to April 2017. The study period was divided into two 16-month periods: from January 2014 to April 2015 in which risk-based screening was performed (period 1), and from January 2016 to April 2017 in which universal screening was performed (period 2). We compared the rates of EONS caused by GBS and other bacterial species between the two periods.
RESULTS
1,301 neonates from 1,293 deliveries and 924 neonates from 913 deliveries were enrolled in period 1 and period 2, respectively. Suspected or culture-proven EONS caused by any organisms were more frequently observed in period 2 (0.7% in period 1 vs. 1.8% in period 2, P=0.013). The causative organism was not confirmed by culture in most cases, except for GBS, Escherichia coli, and Enterococcus. Intrapartum administration of antibiotic prophylaxis (IAP) was more frequently performed in period 2 (10.9% in period 1 vs. 21.5% in period 2, P < 0.001).
CONCLUSION
In spite of the significant increase in IAP rate in the period 2, EONS rates did not decrease by the universal antenatal GBS screening method.

Keyword

Neonatal early onset sepsis; Group B Streptococcal infection; Antenatal screening; Pregnancy

MeSH Terms

Antibiotic Prophylaxis
Cohort Studies
Enterococcus
Escherichia coli
Female
Humans
Infant, Newborn
Korea
Mass Screening*
Methods*
Pregnancy
Pregnant Women
Prenatal Diagnosis
Retrospective Studies
Sepsis*
Streptococcus*