Clinical, economic, and health-related quality of life impact of intrapartum group B Streptococcus (GBS) tests for prevention of neonatal GBS infection: a systematic literature review.
Sheily Kamra, Deepali Moon, Natalie Green et al.
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In 30 seconds
This systematic literature review assessed the clinical performance, economic impact, and health-related quality of life associated with intrapartum group B Streptococcus (GBS) screening. It included 66 studies: 38 clinical, 17 economic, and 11 HRQoL or utility studies. Intrapartum PCR tests returned results in <60 min; four assays met European expert-consensus thresholds of ≥90% sensitivity and ≥95% specificity in at least one study, but only Xpert GBS did so in more than one. Economic studies suggested PCR screening could be cost-neutral or cost-saving compared with antepartum culture, while evidence on long-term HRQoL was limited.
Key findings
- Four PCR assays met ≥90% sensitivity and ≥95% specificity in at least one study; only Xpert GBS met both thresholds in more than one study.
- Intrapartum PCR results were available in <60 min, significantly faster than antenatal culture.
- Economic studies suggested intrapartum PCR could be cost-neutral or generate savings compared with antepartum culture.
- HRQoL studies described substantial risk of physical impairment from long-term sequelae among neonates surviving early-onset GBS disease.
Why it matters
Rapid intrapartum testing may address limitations of antenatal culture and risk-based prophylaxis by identifying GBS colonization closer to delivery. The review also suggests that test costs may be offset by reduced disease-related resource use. However, the evidence base for long-term quality-of-life effects is sparse, so the broader burden and economic implications remain uncertain.
What to keep in mind
The review identified limited primary evidence on HRQoL; diagnostic thresholds were met by only one assay in more than one study.