Integrated monitoring of a new group B streptococcal disease prevention program and other perinatal infections.
OBJECTIVE
To determine levels of prenatal screening for several infections, intrapartum recognition of risk factors, and prophylaxis against mother-to-child transmission of group B streptococcus.


METHODS
Review of stratified random sample of hospital records for deliveries in Connecticut during 1996. SUDAAN analysis was used to adjust for the complex survey design, and weighting adjusted for the probability of being sampled and nonresponse.


RESULTS
Of 992 records requested, 868 (88%) were abstracted and analyzed. Thirty-six percent of women had prenatal screening for group B streptococcus and 26% had been tested for human immunodeficiency virus (HIV), while 97-99% of women had been screened prenatally for hepatitis B surface antigen, rubella, and syphilis. Of those women tested, 17% were detected as group B streptococcus carriers, and 78% of these received intrapartum antibiotic prophylaxis. Among women who were not screened for group B streptococcus prenatally, 22% met risk-based criteria for prophylaxis, but only 45% of these received intrapartum prophylaxis. Among unscreened women with a risk factor, those with shorter hospital stays prior to delivery, admitted on evening or night shifts, or who delivered on the weekend were significantly less likely to receive intrapartum prophylaxis.


CONCLUSIONS
In 1996, the majority of women who delivered in Connecticut were not tested prenatally for group B streptococcus and the majority of those not tested in whom there was an indication for prophylaxis were not treated. Compliance with group B streptococcus prevention recommendations can be improved through increased prenatal testing and/or better recognition of risk-based criteria for intrapartum prophylaxis.
Schuchat
Anne
A
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. acs1@cdc.gov
Roome
Aaron
A
Zell
Elizabeth R
ER
Linardos
Heather
H
Zywicki
Sara
S
O'Brien
Katherine L
KL
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003237:Connecticut; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data*; D013290:Streptococcal Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control* / Q000635:transmission; D013292:Streptococcus agalactiae / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents