Screening pregnant women for GBS not recommended
The latest recommendations from UK National Screening Committee (UK NSC) include not screening pregnant women for group B streptococcus (GBS).
Following a further comprehensive review of the evidence, the independent expert screening committee has not recommended a national screening programme for GBS in pregnancy.
The test currently available cannot accurately distinguish between those mothers whose babies are at risk and those who are not. This means that a large number of women would unnecessarily be offered antibiotics, with the balance of harms and benefits from this approach being unknown.
GBS is one of many common bacteria which occur naturally in both men and women. About 150,000 pregnant women carry GBS each year in the UK and in some cases will pass the bacteria to their baby in labour. This usually causes no ill effects but in a small number of cases it can result in illness. Each year in the UK there are between 400 to 500 cases of early onset GBS, which occurs in the first 7 days of a baby’s life. The vast majority of babies affected by this condition will fully recover with prompt treatment.
It has been suggested that offering screening at a later stage, 35 to 37 weeks of pregnancy, will help detect women carrying GBS who are more at risk of passing on the bacteria during labour. However, the Committee still found that even screening at this later stage would cause more harms with large numbers of people still unnecessarily receiving antibiotics.
Dr Anne Mackie, Director of Programmes for the UK NSC, 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.
The screening committee also recommended against adult screening for alcohol misuse. Alcohol misuse occurs when a person drinks over the recommended units, increasing the possibility of serious health conditions such as heart disease, stroke, liver disease and cancer.
Screening was not recommended because the most common tests for alcohol misuse, the use of questionnaires, are unsuitable when used within a whole population screening programme. With millions being screened, many thousands would be wrongly told they needed follow-on advice when they did not; potentially overwhelming services and reducing access for those who could benefit.
All recommendations will now be considered by ministers.
As part of a regular review process these recommendations will be looked at again in 3 years – or earlier if significant new evidence becomes available.
The latest screening recommendations were made at the UK NSC’s meeting on 8 February 2017. Read recent UK NSC meeting minutes and see upcoming agendas.
Contact the PHE screening press office for more information:
UKHSA press office: screening
Background:
- The UK NSC is independent of, but supported by, PHE.
- The Committee did not recommend screening for 2 further conditions: Antenatal screening for Fetomaternal Alloimmune Thrombocytopenia (FMAIT) and Asymptomatic Bacteriuria (ASB): * FMAIT is a rare genetically inherited condition that prevents a newborn baby’s blood clotting effectively. The condition, in some cases, can cause the mother’s immune system to attack the baby’s blood cells. Screening was not recommended as FMAIT does not harm babies and there is no test which can tell which babies will be harmed, also there is no medical treatment to prevent the condition. * ASB is a urinary tract infection in pregnant women that if left treated, can cause a kidney infection. For mothers this can cause fever, breathing difficulties and kidney failure. It can also cause a baby to be born prematurely, of low birth weight or in some cases, being stillborn. Screening was not recommended as it is not known how many women and babies are affected, and it was not clear when and how often a woman should be screened during pregnancy.
- Read detailed summaries of the recommendations for all of the conditions mentioned.
- Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. PHE is an operationally autonomous executive agency of the Department of Health. Follow us on Twitter @PHE_Screening and our blog https://phescreening.blog.gov.uk.