Table 3.

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

Prevention StrategyAAP, 199231ACOG, 1992 and
1996 (Option 2)1
1996 (Option 1)1
Gotoff and Boyer6Universal
Screening for GBS
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.