Government urged to reconsider screening for group B Strep in pregnancy

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A charity is calling for a re-think on routine screening of pregnant women for group B Strep, after a pilot programme reduced the life-threatening infection in newborn babies.

antenatalclass

Group B Strep Support wants all pregnant women to be routinely screened for the infection

Findings from a pilot study at Northwick Park Hospital in London reveal that screening pregnant women for Group B Streptococcus (GBS) reduced life-threatening infections in newborn babies by 83 per cent.

It comes just weeks after the UK National Screening Committee said there was ‘insufficient evidence’ to introduce GBS screening for all mums-to-be in the UK following a review of evidence.

Unlike other developed countries, pregnant women in the UK are not routinely offered tests to detect group B Strep, the most common cause of life-threatening infection in newborn babies in England, Ireland, Scotland and Wales.

Group B Strep is a normal bacterium carried by around a quarter of women without symptoms. It can be passed from the mother to the baby during birth. However, if it is detected before, women can be given antibiotics during labour to protect their babies from the infection.

The charity Group B Strep Support are now calling on the UK National Screening Committee to re-examine their recommendation in light of the new evidence from Northwick Park Hospital.

According to the charity, providing the Enriched Culture Medium (ECM) test - ecognised as the gold standard for detecting GBS carriage and recommended by Public Health England - on the NHS would cost just £11 per test.

Jane Plumb, chief executive of Group B Strep Support, said, ‘We welcome the results of this study, which demonstrates that antenatal screening for group B Strep carriage works in a busy, complex, multicultural UK setting and reinforces international evidence that group B Strep screening is safe, effective and saves lives and money.
 
‘These findings raise questions about the validity of the UK National Screening Committee’s recommendations last month against introducing routine screening of pregnant women for group B Strep. These results were not included in the review, and the UK NSC should re-examine their recommendation in light of this new evidence.’

Dr Anne Mackie, director of programmes for the UK National Screening Committee, said, 'At the moment there is no test that can distinguish between women whose babies would be affected by GBS at birth and those who would not. This means that screening for GBS in pregnancy would lead to many thousands of women receiving antibiotics in labour when there is no benefit for them or their babies and the harms this may cause are unknown.

'This approach also cuts against the grain of ongoing efforts to reduce the number of people receiving unnecessary antibiotics. Much better evidence is needed on such widespread antibiotic use among pregnant women and whether it is possible to find a more accurate test.'

Pilot screening programme

The screening programme ran for 22 months at Northwick Park Hospital in London. During this time, all women at 35-37 weeks pregnant were offered testing for GBS.

Over 6,000 pregnant women chose to have the test, which involved taking two swabs. If GBS was found, they were offered intravenous antibiotics during labour.

Previously the hospital had one of the highest rates of GBS infection in newborn babies in the country at almost three times the national average.

However, during the study, only three newborn babies developed GBS infection, two of which were born to mothers who had not been screened. This is a fall in the rate of GBS infection in newborn babies of 66 per cent overall, and 83 per cent in babies born to screened mothers.

Dr Gopal Rao, consultant microbiologist at Northwick Park Hospital, said, ‘Our hospital’s rate of group B Strep infection was much higher than the national average, despite carefully following national guidelines. This meant we were seeing more and more babies sick with group B Strep infection. 
 
‘I looked at international evidence showing how well screening worked overseas, and wondered if it could work as well in the UK.

‘Our pilot study has demonstrated that not only is screening do-able in a UK setting, it had an even greater effect than we had expected. We are delighted with our findings, and hope comparable results can be seen across the UK.’

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