Routine testing for Group B Streptococcus

  • Research type

    Research Study

  • Full title

    The clinical and cost-effectiveness of testing for Group B Streptococcus: a cluster randomised trial with economic and acceptability evaluations (GBS3)

  • IRAS ID

    263682

  • Contact name

    Jane Daniels

  • Contact email

    jane.daniels2@nottingham.ac.uk

  • Sponsor organisation

    University of Nottingham

  • ISRCTN Number

    ISRCTN49639731

  • Duration of Study in the UK

    2 years, 5 months, 30 days

  • Research summary

    Group B Streptococcus (GBS) is a bacterium present in the vagina of approximately 1 in 4 pregnant women.

    Giving women antibiotics in labour reduces the risk of their babies developing GBS infection. Current UK practice is to offer antibiotics when the baby is at higher risk of developing the infection based on maternal risk factors. This “risk factor” screening is imperfect: some babies born to mothers without risk factors still develop an infection and many women with risk factors do not carry GBS but receive antibiotics unnecessarily. A better solution is “routine testing” of every pregnant woman, and offering antibiotics in labour to those who are carrying GBS. There are two methods available.

    80 maternity units will be randomly allocated to the “risk factor” or the “routine testing” approach. Those allocated to the “routine testing” approach will be further randomly divided into testing women using a vaginal-rectal swab either a) at 35-37 weeks of pregnancy, or b) in labour, using a rapid test. Women with a positive test result will be offered antibiotics in labour. We will compare the number of babies who develop serious infection. As infections are relatively rare, we will need to collect information on 320,000 women to be able to see a difference between the approaches. We will use routinely collected data from national systems. We will also interview women and healthcare professionals about the acceptability of the testing approaches. We will collect individual level detailed data for 100 women at each of the 80 sites to inform the economic evaluation of the trial and for monitoring purposes. Finally, we will compare the overall costs of each strategy to ascertain which represents the best value for money for the NHS.

  • REC name

    East Midlands - Derby Research Ethics Committee

  • REC reference

    19/EM/0253

  • Date of REC Opinion

    16 Sep 2019

  • REC opinion

    Further Information Favourable Opinion