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Updated: May 23, 2026
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Cost and effectiveness of intrapartum group B streptococcus polymerase chain reaction screening for term deliveries
Najoua El Helali1, Yves Giovangrandi, Kathleen Guyot
1Groupe Hospitalier Paris-Saint-Joseph, Paris, France. nelhelali@hpsj.fr
Insights
Intrapartum polymerase chain reaction (PCR) screening for group B streptococcal (GBS) disease is cost-neutral and reduces neonatal GBS infections compared to antenatal culture screening. This PCR strategy offers a significant decrease in early-onset GBS disease.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Medicine
- Infectious Diseases
Background:
- Group B Streptococcus (GBS) poses a risk for early-onset neonatal disease.
- Antenatal vaginal culture screening is the recommended method in France.
- Intrapartum screening strategies are being explored for improved outcomes.
Purpose of the Study:
- To compare the cost and consequences of intrapartum polymerase chain reaction (PCR) screening versus antenatal culture for GBS disease.
- To evaluate the impact on early-onset GBS disease in newborns.
Main Methods:
- A single-institution study compared intrapartum PCR screening (2010) with antenatal culture screening (2009).
- Exhaustive monitoring of early-onset GBS disease in newborns was conducted.
- Direct costs, including screening and hospital costs, were estimated and compared on an intention-to-treat basis.
Main Results:
- The GBS colonization rate was higher with intrapartum PCR (16.7%) compared to antenatal culture (11.7%).
- The overall probability of neonatal GBS disease decreased from 0.9% to 0.5% with intrapartum PCR.
- Average total cost per delivery was similar ($1,759 in 2009 vs. $1,754 in 2010), but the number and severity of GBS cases were lower in 2010.
Conclusions:
- Intrapartum PCR screening for GBS is cost-neutral compared to antenatal culture screening.
- The intrapartum PCR strategy significantly reduced the incidence of early-onset GBS disease in newborns.
Objective:
To estimate the cost and consequences of intrapartum polymerase chain reaction (PCR) screening on early-onset group B streptococcal (GBS) disease compared with the antenatal lower vagina culture screening recommended in France.
Methods:
This was a single-institution study comparing the intrapartum PCR screening strategy implemented in 2010 with antenatal culture strategy in place in 2009. Early-onset GBS disease in newborns was monitored exhaustively. We estimated direct costs, including screening test costs and hospital costs, for deliveries of healthy newborns compared with those infected with GBS. Costs in 2009 and 2010 were compared on an intention-to-treat basis.
Results:
Term deliveries were 2,761 and 2,814 in 2009 and 2010, respectively. Among the screened mothers, the vaginal GBS colonization rate was 11.7% based on antenatal GBS culture screening in 2009 compared with 16.7% in 2010 using the intrapartum PCR testing. The overall probabilities of neonatal GBS disease were 0.9% compared with 0.5%, and the average total cost per delivery was $1,759±1,209 in 2009 compared with $1,754±842 in 2010 (P=.9) in antenatal and intrapartum screening strategies, respectively. The number and severity of cases of early-onset GBS disease and the resulting hospital costs were higher in 2009.
Conclusion:
Polymerase chain reaction intrapartum screening strategy was cost-neutral when compared with the 2009 antenatal lower vagina culture screening, with a significant decrease in early-onset GBS disease.
