Abstract
Problem
Despite the introduction of preventive guidelines, no decrease in the incidence of
early onset infection was observed.
Background
Early onset group B streptococcal (EOGBS) infection is an important cause of neonatal
morbidity and mortality.
Aim
Our study was conducted to determine adherence to three guideline-based group B streptococcus
(GBS) preventive strategies.
Methods
A prospective experimental study clustered by obstetric collaboration region was performed
between March 2013 and August 2014 among midwives, obstetricians and paediatricians
in the Netherlands. At baseline, the three regions operated according to the Dutch
preventive strategy (founded on the risk-based strategy) in order to prevent EOGBS
infection, whereas in the study period they followed either the risk-based, the combination
or the Dutch strategy. Adherence was measured prospectively per pregnant woman, using
predefined core elements of each preventive strategy: identification of risk factors,
maternal GBS screening, application of intrapartum antibiotic prophylaxis and observation
of the child. Data about adherence to the core elements were collected from medical
records, maternal questionnaires and laboratory test results.
Findings
In the three regions, a total of 121 care providers and 1562 women participated.
We found an overall adherence of 90% to the risk-based strategy, 57% to the combination
strategy and 89% to the Dutch strategy. Adherence to a strategy in case women had
EOGBS risk factors was below 20% in all strategies.
Discussion
The majority of women with EOGBS risk factors did not receive the care prescribed
by any of three preventive strategies and were not treated optimally.
Conclusion
The risk-based and the Dutch strategy are the recommended strategies for implementation.
Abbreviations:
GBS (Group B streptococcus), EOGBS (Early onset group B streptococcus), IAP (Intrapartum antibiotic prophylaxis), PCR (Polymerase chain reaction)Keywords
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Article info
Publication history
Published online: December 21, 2019
Accepted:
December 15,
2019
Received in revised form:
December 12,
2019
Received:
June 2,
2019
Identification
Copyright
© 2019 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
