Abstract
BackgroundActions to prevent early onset disease in neonates are based on different strategies including administering antibiotic prophylaxis during labour in case of 1) maternal GBS colonisation (screening strategy), 2) identified risk factors (risk-based strategy) or 3) a combination of these two conditions (maternal GBS colonisation and identified risk factors: combination strategy and the Dutch guideline). Low adherence to guidelines preventing EOGBS has been reported. Each strategy has drawbacks and clinical outcomes are affected by care providers’ and women’s adherence. The actual impact of any preventive strategy is the product of efficacy of the strategy and the level of implementation. In order to reduce neonatal death due to EOGBS by developing the optimal guideline, we analysed barriers and facilitators of current used strategies.MethodsFocus group and personal interviews with care providers and women were performed. Impeding and enhancing factors in adherence to the preventive strategies were discussed and scored using the Measurement Instrument for Determinants of Innovations (MIDI) and analysed by two independent researchers.ResultsOverall, care providers identified 3.6 times more factors that would impede (n = 116) rather than facilitate (n = 32) adherence to the preventive strategies. 28% facilitative factors were reported in relation to the combination strategy and 86% impeding factors in relation to the Dutch guideline. The most preferred strategy was the combination strategy by 74% of the care providers and by 86% of the women.DiscussionWe obtained a detailed understanding of factors that influence adherence to preventive strategies.This insight can be used to develop implementation activities to improve the uptake of new strategies.Trial registrationThe trial is registered in the Dutch Trial Register NTR3965.
Highlights
Actions to prevent early onset disease in neonates are based on different strategies including administering antibiotic prophylaxis during labour in case of 1) maternal group B streptococcal (GBS) colonisation, 2) identified risk factors or 3) a combination of these two conditions
Background early-onset group B haemolytic streptococcus disease (EOGBS) is rare, it remains an important cause of perinatal mortality and long-term morbidity for the neonate and child [3, 4]
Risk factors include a previous child with EOGBS and risk factors in the current pregnancy including group B streptococcal (GBS) bacteriuria, intrapartum fever, preterm
Summary
Actions to prevent early onset disease in neonates are based on different strategies including administering antibiotic prophylaxis during labour in case of 1) maternal GBS colonisation (screening strategy), 2) identified risk factors (risk-based strategy) or 3) a combination of these two conditions (maternal GBS colonisation and identified risk factors: combination strategy and the Dutch guideline). The main cause of neonatal infection in the first week of Different preventive strategies are currently used based on identifying women at risk, either by screening for GBS colonisation and/or by identifying risk factors for EOGBS. All GBS-colonised women or women with unknown GBS status receive IAP. This strategy is not used in the Netherlands
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
