Selective or universal screening for GBS in pregnancy (review)

Area of Science:

• Obstetrics and Gynecology
• Neonatal Medicine
• Infectious Diseases

Background:

• Group B Streptococcus (GBS) is a leading cause of neonatal sepsis, contributing to significant worldwide perinatal morbidity and mortality.
• Current prevention strategies, including intrapartum antibiotic prophylaxis and universal screening, have limitations in preventing early-onset GBS disease and do not address late-onset disease.
• Evidence gaps exist regarding the optimal targeting of prevention strategies, whether by clinical risk factors or GBS colonization screening.

Purpose of the Study:

• To review current strategies for preventing early-onset Group B Streptococcus disease.
• To evaluate the effectiveness and potential harms of universal GBS screening.
• To explore future directions in GBS prevention, including rapid point-of-care testing and maternal vaccination.

Main Methods:

• Literature review of existing studies on GBS prevention strategies.
• Analysis of the benefits and harms associated with universal GBS screening.
• Discussion of the potential of novel screening methods and maternal vaccines.

Main Results:

• Intrapartum antibiotic prophylaxis is standard but its targeting remains debated.
• Universal bacteriological screening is common but its overall benefit and harm profile require further clarification.
• Rapid point-of-care tests need validation through randomized controlled trials.

Conclusions:

• Existing GBS prevention methods are insufficient to protect against all forms of GBS disease.
• Maternal vaccination against GBS presents a promising future approach to significantly reduce the global burden of invasive GBS disease.
• Further research is needed to optimize screening and evaluate new interventions like maternal vaccines.