ACOG Committee Opinion: number 279, December 2002. Prevention of early-onset group B streptococcal disease in newborns.

During the past two decades, group B streptococci (GBS), or Streptococcus agalactiae, has emerged as an important cause of perinatal morbidity and mortality. Intrapartum administration of antibiotics to the woman (during labor or after rupture of membranes, but before delivery) has been demonstrated to reduce early-onset neonatal GBS disease. In 1996, the federal Centers for Disease Control and Prevention (CDC), the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics recommended that obstetric providers adopt either a culture-based or a risk-based approach for the prevention of early-onset GBS. A recent multistate retrospective cohort study of live births in 1998 and 1999 of residents from eight areas of the Active Bacterial Core Surveillance/Emerging Infections Program network suggests that the culture-based approach is superior to the risk-based approach. The Committee on Obstetric Practice supports the new CDC recommendations that obstetric providers adopt a culture-based strategy for the prevention of early-onset GBS disease in the newborn. It is important to acknowledge that complete implementation of this complex strategy will not eliminate all cases of early-onset GBS.