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

  • 1Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.


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.
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.
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).
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.


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

MeSH Terms

Antibiotic Prophylaxis
Cohort Studies
Escherichia coli
Infant, Newborn
Mass Screening*
Pregnant Women
Prenatal Diagnosis
Retrospective Studies


  • Fig. 1 The flow chart of universal GBS screening in the period 2. Excluding fetal major malformation and preterm delivery, universal GBS screening was applicable to 913 women. Among them, 795 women underwent universal GBS screening.

  • Fig. 2 Isolated microorganisms in the universal GBS screening period. The rate of GBS colonization was found to be 7.9%. Other than GBS, E. coli and Candida accounted for 18.6% and 6.3% of isolated organism, respectively. E. coli, Escherichia coli; GBS, Group B Streptococcus; S. aureus, Staphylococcus aureus.


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