[WHO recommendation on screening of pregnant women for intrapartum antibiotic prophylaxis for the prevention of early onset Group B streptococcus disease in newborns].

Group B Streptococcus (GBS) colonisation affects around 13% of pregnant women and increases the risk of peripartum infection in newborns, preterm delivery and premature rupture of membranes. GBS infections are a major cause of neonatal sepsis. Early onset GBS (EOGBS) infections in the first seven days of life are particularly dangerous for newborns. Prevention is achieved by intrapartum antibiotic prophylaxis following a positive GBS screening during pregnancy. Screening strategies in pregnant women include universal GBS screening using a rectovaginal swab, assessment of maternal risk factors for EOGBS infection as a risk-based strategy, or a combination of both.The aim of this World Health Organization (WHO) recommendation was to improve the quality of care and outcomes for pregnant women and neonates with regard to the prevention of EOGBS. Consequently, there is a need to develop appropriate screening strategies for GBS in order to initiate intrapartum antibiotic prophylaxis.This recommendation was developed by a group of independent international experts and complements the existing recommendation on intrapartum antibiotic prophylaxis for positive GBS. It was developed in accordance with the WHO guideline development manual. This includes identification of key questions and outcomes, appraisal of the evidence, grading of the evidence using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach, and formulation of the recommendation by the guideline group, considering additional factors such as cost, pregnant women's and family values and preferences, as well as impact on health equity.WHO recommends that pregnant women be screened for the need for intrapartum antibiotic prophylaxis to reduce the risk of EOGBS infection. Either universal antenatal GBS screening or a risk-based strategy should be offered as a screening strategy. Pregnant women with a positive test result or at increased risk should receive intrapartum antibiotic prophylaxis.