Outcome of a screening programme for the prevention of neonatal invasive early-onset group B Streptococcus infection in a UK maternity unit: an observational study
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  • Published on:
    Gaps in the evidence base
    • Robert JC Steele, Chair UK National Screening Committee
    • Other Contributors:
      • Farah Seedat, Researcher
      • Sian Taylor-Phillips, Associate Professor

    We are grateful to the authors of “Outcome of a screening programme for the prevention of neonatal invasive early-onset group B Streptococcus infection in a UK maternity unit:
    an observational study” for publishing the results of the screening programme for GBS carriage at Northwick Park Hospital.1 The impetus behind the programme was clearly driven by concern for the health of newborn babies and enthusiasm to reduce the rate of EOGBS in the hospital’s population.

    However, the national policy on culture based screening at 35-37 weeks gestation is that this should not be offered. In large part this is informed by concern about the screening test’s inability to reliably distinguish between women whose babies would be affected by EOGBS and those whose babies would not. The consequence of this is a high rate of overdiagnosis and subsequent overtreatment. The Northwick Park experience provides an insight into this which was not brought out in the paper.

    The paper reports an EOGBS rate of 0.99 / 1000 deliveries prior to screening and a GBS carriage rate of 29% in the population. With 9098 live births in the study period 9 cases of EOGBS in approximately 2600 carriers would be expected. Screening at 35 – 37 weeks aims to identify these carriers and offer IAP to reduce the risk of EOGBS. From what is presented in the paper regarding transmission rates, and elsewhere regarding test accuracy,2,3 between 60% and 80% of these carriers would be eligible for IAP wh...

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    Conflict of Interest:
    Robert Steele is Chair of the UK National Screening Committee. The UK National Screening Committee (UK NSC) advises ministers and the NHS in the 4 UK countries about all aspects of population screening and supports implementation of screening programmes

    Farah Seedat and Sian Taylor-Phillips undertook an independent review of the evidence related to screening for Group B Streptococcus in 2016 for the UK National Screening Committee.