GBS Screening Not Cost-Effective in Repeat Cesarean Delivery
Streptococcus agalactiae. Photo Credit: CDC via Wikimedia Commons.
HealthDay News — For women with a singleton pregnancy planning a repeat cesarean delivery, universal group B streptococci (GBS) screening is not cost-effective, according to a study published in Obstetrics & Gynecology.
Catherine M. Albright, MD, from the University of Washington in Seattle, and colleagues compared the cost-effectiveness of GBS screening for women planning a repeat cesarean delivery. With universal screening, prophylactic antibiotics were given to all GBS-positive women who labored before a scheduled cesarean delivery. With no screening, antibiotic receipt was based on risk-based criteria for women who presented in labor.
The researchers found that universal GBS screening was not cost-effective in women planning a repeat cesarean delivery compared with no screening, with a cost of $114,445 per neonatal quality-adjusted life-year gained. To prevent an adverse outcome from GBS, the cost exceeded $400,000. Universal screening became cost-effective if more than 28% of women were GBS-positive, more than 29% labored before their scheduled delivery, or more than 10% delivered vaginally.
"Universal GBS screening in women with a singleton pregnancy planning a repeat cesarean delivery may not be cost-effective in all populations," the authors write. "However, in populations with a high GBS prevalence, women at high risk of laboring before their scheduled cesarean delivery, or women who may ultimately opt for a vaginal delivery, GBS screening may be cost-effective."
Albright CM, MacGregor C, Sutton D, Theva M, Hughes BL, Werner EF. Group B Streptococci screening before repeat cesarean delivery: a cost-effectiveness analysis. Obstet Gynecol. 2017;129:111-119. doi: 10.1097/AOG.0000000000001800