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Barriers to Implementing the Group B Streptococcal Prevention Guidelines
Author(s) -
Cárdenas Vicky,
Davis Robert L.,
Hasselquist Mary Beth,
Zavitkovsky Ann,
Schuchat Anne
Publication year - 2002
Publication title -
birth
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.233
H-Index - 83
eISSN - 1523-536X
pISSN - 0730-7659
DOI - 10.1046/j.1523-536x.2002.00203.x
Subject(s) - group (periodic table) , medicine , chemistry , organic chemistry
Background: Group B streptococcal disease is the leading cause of neonatal sepsis in the United States. We assessed predictors of compliance with the consensus guidelines for perinatal group B streptococcus disease prevention at two Group Health Cooperative hospitals. Methods: A descriptive and cohort analysis was conducted of failure to comply with the screening‐based approach to group B streptococcus prevention among singleton birth pregnancies in two Group Health Cooperative hospitals, September 1, 1996 to December 31, 1997. We studied determinants of failure to screen pregnant women for group B streptococcus at 35 to 37 weeks’ gestation and failure to deliver intrapartum antibiotic prophylaxis to Group B streptococcus‐positive women. Results: Nearly 28 percent of 1969 women delivering at two Group Health Cooperative hospitals were not screened appropriately for group B streptococcus. Women who were not screened properly were more likely to be in their teens. A short length of hospital stay before delivery was the strongest predictor of the lack of administration of intrapartum antibiotic prophylaxis to infected multiparas at delivery. Group B streptococcus‐positive women without pregnancy complications were less likely to receive intrapartum antibiotic prophylaxis than infected women with complications. Conclusions: The findings of this study suggest that to improve group B streptococcus disease prevention, screening efforts should focus on teenage women, and intrapartum antibiotic prophylaxis delivery efforts should be aimed at low‐risk women with precipitous labor. (BIRTH 29:4 December 2002)