Table 3.

Proposed Strategies for Prevention of Early-onset Neonatal Group B Streptococcal Infections

Prevention StrategyAAP, 199231ACOG, 1992 and
CDC-AAP-ACOG,
1996 (Option 2)1
CDC-AAP-ACOG,
1996 (Option 1)1
Gotoff and Boyer6Universal
Intrapartum
Prophylaxis
Screening for GBS
colonization
Rectovaginal culture at 28 weeksNoneRectovaginal culture at 35–37 weeksRectovaginal culture at 35–37 weeksNone
Criteria for intrapartum prophylaxisGBS screen + and EGA <37 weeks or risk factor* + EGA <37 weeks or risk factor*+GBS screen + or EGA <37 weeks or risk factor* + and GBS status unknownGBS screen + and risk factor* or delivery before GBS screening doneAll parturients
Criteria for neonatal prophylaxisGBS screen +
Patients treated per 1000 births37171307323 1000
Patients treated per case prevented38106136142415
GBS cases prevented (%)32.953.875.175.680.2
Cost per case prevented$22 215$3067$11 925$9720$12 049
  • Abbreviations: AAP, American Academy of Pediatrics; ACOG, American College of Obstetricians and Gynecologists; CDC, Centers for Disease Control and Prevention; GBS, group B streptococcus; +, positive.

  • * Prolonged rupture of membranes >18 hours or intrapartum maternal fever >38°C.

  • 118.4 mothers and 204.3 infants.