|March 2011 · Vol. 23, No. 3
New group B strep guidelines
clarify management of key groups
The CDC’s latest recommendations, endorsed by ACOG, spell out screening and intrapartum prophylaxis among women who experience preterm labor, preterm premature rupture of membranes, group B Streptococcus in urine, and allergy to penicillin
Before widespread intrapartum prophylaxis against group B Streptococcus (GBS) was initiated in the late 1990s, roughly 7,500 newborns developed invasive GBS disease every year in the United States, and the case-fatality rate reached an astonishing—and disheartening—50%.1 Now that all pregnant women undergo culture-based screening at 35 to 37 weeks’ gestation, the incidence of early-onset neonatal GBS disease has declined precipitously.
According to a report issued late last year by the Centers for Disease Control and Prevention (CDC), GBS now causes roughly 1,200 cases of early-onset invasive disease every year, approximately 70% of them among infants born at or after 37 weeks’ gestation, and the case-fatality rate is 4% to 6%.2 Mortality is higher among preterm infants, with a case-fatality rate of 20% to 30% for infants born at or before 33 weeks’ gestation, compared with 2% to 3% for full-term infants.2