Maternal screening in prevention of neonatal infections: current status and rationale for group B streptococcal screening.

Maternal screening--either selective or universal--is an accepted component of a number of strategies for prevention of congenital and perinatal infections. Using the results of maternal screening at prenatal visits and the presence of perinatal risk factors during labour, neonatal group B streptococcal (GBS) early-onset disease can be prevented by selective intrapartum chemoprophylaxis. Possible variations on this strategy may employ semiquantitative tests for GBS colonization at prenatal visits or, possibly, rapid bacterial diagnosis intrapartum. Based on the incidence and economic impact of GBS disease, selective intrapartum chemoprophylaxis appears cost-effective in United States populations, but may not be so in countries with lower incidence rates.