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Universal antenatal group B streptococcus screening? The opinions of obstetricians and neonatologists within
1Department of Obstetrics and Gynaecology, Adelaide University, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
Insights
Australian healthcare professionals have mixed opinions on screening for Group B Streptococcus (GBS) in pregnant women to prevent newborn infections. Most support either universal or risk-factor-based antenatal screening.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Group B Streptococcus (GBS) is a primary cause of neonatal morbidity and mortality in Australia.
- Intrapartum chemoprophylaxis is recommended to mitigate GBS transmission, but optimal screening strategies remain debated.
Purpose of the Study:
- To survey Australian obstetricians and neonatologists regarding their views on GBS screening and treatment protocols.
- To identify current practitioner opinions on managing the risk of neonatal GBS sepsis.
Main Methods:
- A survey was distributed to obstetricians and neonatologists practicing in Australia.
- Response rates were analyzed to determine support for universal versus risk-factor-based antenatal GBS screening.
Main Results:
- A majority of responding obstetricians (56%) and neonatologists (61%) favored universal antenatal GBS screening.
- Among those not supporting universal screening, a significant majority (93% of obstetricians, 92% of neonatologists) supported risk-factor-based antenatal screening.
Conclusions:
- There is considerable diversity in Australian practitioner opinions on GBS screening and management.
- This highlights ongoing uncertainty in the medical literature regarding the most effective strategy to prevent neonatal GBS sepsis.
Abstract:
Group B streptococcus (GBS) is the leading infectious cause of morbidity and mortality in Australian newborns. Although intrapartum chemoprophylaxis is recommended to reduce the risk of neonatal GBS transmission and disease, controversy exists as to the best method to select women 'at risk' for this treatment. Our study aimed to survey the opinions of obstetricians and neonatologists currently in practice in Australia on GBS screening and treatment. Of the 488 obstetricians and 68 neonatologists currently in practice who responded to the survey, 271 obstetricians (56%) and 40 neonatologists (61%) supported universal antenatal screening. Of those respondents who did not support a universal antenatal screening policy, 196 (93%) and 24 (92%) of the obstetricians and neonatologists respectively, supported antenatal screening based on risk factors. This diversity in practitioner opinion highlights the lack of certainty in the literature as to the best management strategy to prevent neonatal GBS sepsis.