title: Cost and effectiveness of intrapartum group B streptococcus polymerase chain reaction screening for term deliveries.
abstract: OBJECTIVE
  To estimate the cost and consequences of intrapartum polymerase chain reaction (PCR) screening on early-onset group B streptococcal (GBS) disease compared with the antenatal lower vagina culture screening recommended in France.
  
  
  METHODS
  This was a single-institution study comparing the intrapartum PCR screening strategy implemented in 2010 with antenatal culture strategy in place in 2009. Early-onset GBS disease in newborns was monitored exhaustively. We estimated direct costs, including screening test costs and hospital costs, for deliveries of healthy newborns compared with those infected with GBS. Costs in 2009 and 2010 were compared on an intention-to-treat basis.
  
  
  RESULTS
  Term deliveries were 2,761 and 2,814 in 2009 and 2010, respectively. Among the screened mothers, the vaginal GBS colonization rate was 11.7% based on antenatal GBS culture screening in 2009 compared with 16.7% in 2010 using the intrapartum PCR testing. The overall probabilities of neonatal GBS disease were 0.9% compared with 0.5%, and the average total cost per delivery was $1,759±1,209 in 2009 compared with $1,754±842 in 2010 (P=.9) in antenatal and intrapartum screening strategies, respectively. The number and severity of cases of early-onset GBS disease and the resulting hospital costs were higher in 2009.
  
  
  CONCLUSIONS
  Polymerase chain reaction intrapartum screening strategy was cost-neutral when compared with the 2009 antenatal lower vagina culture screening, with a significant decrease in early-onset GBS disease.
authors.affiliation: Groupe Hospitalier Paris-Saint-Joseph, Paris, France. nelhelali@hpsj.fr
authors.forename: Najoua
authors.initials: N
authors.lastname: El Helali
authors.forename: Yves
authors.initials: Y
authors.lastname: Giovangrandi
authors.forename: Kathleen
authors.initials: K
authors.lastname: Guyot
authors.forename: Karine
authors.initials: K
authors.lastname: Chevet
authors.forename: Laurent
authors.initials: L
authors.lastname: Gutmann
authors.forename: Isabelle
authors.initials: I
authors.lastname: Durand-Zaleski
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D005602:France; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008403:Mass Screening / Q000191:economics*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D013290:Streptococcal Infections / Q000175:diagnosis*; D013292:Streptococcus agalactiae / Q000302:isolation & purification*; D047929:Term Birth; D014626:Vaginal Smears / Q000191:economics