A Revised Strategy for the Prevention of Group B Streptococcal Infection in Pregnant Women and Their Newborns.

Group B beta-hemolytic Streptococcus (GBS) is the leading cause of life-threatening perinatal infection of newborns in developed countries. Because a vaccine is not yet available, selective intrapartum chemoprophylaxis is the best current strategy for preventing disease. Joint recommendations of the Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics (AAP) are that all pregnant women be screened for GBS at 35 to 37 weeks of gestation. Pregnant women who are colonized with GBS should be treated with intravenous penicillin during labor. Women who have not been screened but exhibit risk factors known to be associated with GBS disease, such as preterm labor and/or membrane rupture at fewer than 37 weeks' gestation, intrapartum fever, and prolonged rupture of membranes > 18 hours, should also receive intrapartum antibiotics if they begin labor. Women with a history of GBS disease, such as a prior episode of GBS bacteriuria or a previous newborn with invasive GBS disease, are at high risk for recurrent GBS infection. The latter 2 categories in particular warrant chemoprophylaxis regardless of colonization status.