Group B Streptococcus Screening and Treatment Adherence in Pregnancy: A Retrospective Cohort Study and Opportunities for Improvement

•Screening for Group B streptococcus (GBS) impacts many maternal–fetal outcomes.•GBS screening guidelines are continually evolving and compliance varies.•Via a retrospective cohort study, we found high (89%) adherence across providers.•Significant differences in compliance were found between clinic...

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Published in:AJPM Focus 2022-12, Vol.1 (2), p.100028-100028, Article 100028
Main Authors: Santillan, Donna A., Hubb, Alexander J., Nishimura, Taryn E., Rosenfeld-O'Tool, Sandra, Schroeder, Kathleen J., Conklin, Jona M., Karras, Alexandra E., Gumusoglu, Serena B., Brandt, Debra S., Miller, Emily, Hunter, Stephen K., Santillan, Mark K.
Format: Article
Language:English
Subjects:
Group B Streptococcus
Guideline adherence
Infection
Pregnancy
Screening
Treatment
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Summary:•Screening for Group B streptococcus (GBS) impacts many maternal–fetal outcomes.•GBS screening guidelines are continually evolving and compliance varies.•Via a retrospective cohort study, we found high (89%) adherence across providers.•Significant differences in compliance were found between clinic subsets.•High compliance may attenuate antibiotic resistance. Pregnancy is a time of increased healthcare screening, and past adherence to evolving guidelines inform best practices. While studies of Group B streptococcus (GBS) guideline adherence have focused primarily on treatment of GBS carriers, this study broadly evaluated long-term adherence to both GBS screening and treatment guidelines. Adherence was evaluated across provider types (Obstetrics and Gynecology, Certified Nurse Midwives, and Family Medicine). We conducted a retrospective cohort study. Demographic and clinical information were extracted from all prenatal care and delivery patients at a single institution in a single year (Institutional Review Board Approval# 201207778). Vancomycin prescriptions in pregnancy were tracked for 10 years to determine long-term adherence. Adherence was defined as no deviation from 2010 GBS screening and treatment guidelines. Adherence occurred in 89% (1610/1810) of patients. Reasons for deviations from guidelines could not always be determined. There was no significant difference in maternal age, race, prenatal provider type, provider type at delivery, gestational age at delivery, delivery mode, or whether antibiotic sensitivities were performed between complaint and non-compliant groups. Significant differences in adherence were found between Obstetric clinics (High Risk Obstetrics Clinic, Maternal Fetal Medicine Fellows Clinic, Continuity of Care Clinic, and Faculty Private Clinic) (P
ISSN:2773-0654
2773-0654
DOI:10.1016/j.focus.2022.100028