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GBS Screening Guidelines Widely Followed in Tennessee

Compliance with perinatal group B streptococci rules high; timing, chemoprophylaxis often not optimal

FRIDAY, June 4 (HealthDay News) -- The state of Tennessee has mostly succeeded in implementing and adhering to universal screening guidelines for perinatal group B streptococci (GBS), but the timing of screening and administration of chemoprophylaxis when indicated could be improved upon, according to research published in the June issue of Obstetrics & Gynecology.

William P. Goins, M.D., of the Baylor College of Medicine in Houston, and colleagues conducted a retrospective study of all live births in surveillance hospitals in 2003 to 2004 to estimate compliance with the 2002 revised GBS prevention guidelines in Tennessee. The guidelines recommend universal GBS screening of pregnant women at 35 to 37 weeks' gestation, with administration of intrapartum chemoprophylaxis when indicated.

The researchers found that screening was performed for 84.7 percent of pregnant women, but 26.3 percent of the prenatal tests were performed before 35 weeks' gestation. Of those women with an indication for GBS prophylaxis, 61.2 percent received optimal and timely chemoprophylaxis. Women who did not receive optimal chemoprophylaxis were more likely to have a penicillin allergy or preterm delivery, and were also less likely to have received recommended prenatal serologic testing for other infectious diseases. About 25 percent of infants who did develop early GBS were born to mothers who had been treated appropriately and according to the guidelines.

"Universal prenatal GBS screening was implemented widely in Tennessee, although the timing of screening and administration of chemoprophylaxis often were not optimal. A substantial burden of early-onset GBS disease occurs despite optimal prenatal screening and chemoprophylaxis, suggesting that alternative strategies, such as vaccination, are needed," the authors write.

One author received free vaccines from Sanofi-Pasteur for a CDC-funded research study.

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