Zou Li is a chief physician, professor, and doctoral supervisor at the Union Hospital, affiliated with Tongji Medical College of Huazhong University of Science and Technology. Deputy Director of the Perinatal Medicine Society of the Hubei Medical Association and a member of the Obstetrics Group of the Obstetrics and Gynecology Branch of the Chinese Medical Association, Member of the Hypertensive Disorders in Pregnancy Group, Obstetrics and Gynecology Branch of the Chinese Medical Association; Chinese Medical Association, Obstetrics and Gynecology Society. Deputy Director of the Wuhan Branch and a member of the editorial boards of journals including the Chinese Journal of Perinatal Medicine.

The 9th Conference on Obstetric Critical Care (9th COCC) and the 2nd Conference on Normal Delivery (2nd CCND) were held from September 11, 2014— The conference was held in Wuhan, Hubei, on September 14. During the event, Professor Zou Li delivered a keynote address on whether and how to implement prenatal screening for Group B Streptococcus (GBS) in China. He delivered a keynote address, and afterward, media reporters conducted an exclusive interview with him on the topic.

Reporter ： Hello, Professor Zou! I was fortunate to attend your presentation at this conference on the topic of GBS screening in China, and it was truly outstanding. What led you to…? Why choose this topic?

Professor Zou Li The conference organizing committee believes this topic is highly representative, as GBS screening is gaining momentum nationwide, yet many people remain uncertain about its necessity. Clearly, therefore, I shared my learning insights with all my colleagues.

In the 1970s, the United States and European countries widely recognized and demonstrated that GBS infection is a major pathogen responsible for perinatal morbidity. GBS causes d. The consequences of maternal–neonatal infection are very serious. For the mother, GBS infection may lead to preterm labor, premature rupture of membranes, and chorioamnionitis; for the newborn, Early-onset neonatal infections can lead to sepsis, pneumonia, and disseminated intravascular coagulation (DIC), and may even be life‑threatening; the mortality rate of GBS infection in newborns is… Approximately 5%. In 1996, the U.S. Centers for Disease Control and Prevention (CDC) issued the “Guidelines for Screening and Prevention of Perinatal Group B Streptococcus Infection,” which have been widely adopted… With the support of the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics, it was subsequently revised in 2002 and 2010. Following its publication, it has significantly reduced… It has reduced the incidence and severity of perinatal GBS infections, with the incidence of early-onset neonatal infection declining by approximately 80%. This guideline recommends screening for GBS infection. Patients receive prophylactic and intrapartum treatment to prevent postpartum infection.

There are mainly two options:

Scheme I is screening followed by treatment:

1) Perform GBS bacterial testing on all pregnant women at 35–37 weeks of gestation. Liquid selective chromogenic culture, Screening Results Positive cases undergo preliminary… Preventive treatment;

2) If there is a history of GBS infection in the previous newborn, this… If GBS bacteriuria is detected in a subsequent pregnancy and delivery occurs before 37 weeks of gestation, prophylactic treatment should also be administered.

3) For pregnant women whose GBS colonization status is unknown, prophylactic treatment should be administered under the following conditions: intrapartum fever ≥38°C and membrane rupture lasting ≥18 hours.

Regimen II involves bypassing screening and administering prophylactic treatment directly when the following high-risk factors are present: delivery before 37 weeks of gestation, or a maternal body temperature ≥38°C during labor. Membrane rupture lasting ≥18 hours, a history of GBS infection in the previous newborn, and GBS bacteriuria during this pregnancy.

The carriage rate among pregnant women detected through routine screening ranges from 10% to 30%, varying across countries; it is approximately 10% in the United States, about 14% in the United Kingdom, and 7.6% in Beijing. Among newborns delivered by GBS‑carrying pregnant women, the carriage rate of GBS ranges from 40% to 70%. With inadequate management, approximately 1% to 3% may develop invasive infections, and 1% to 3% of these newborns… The mortality rate in is approximately 5%.

The main issues in GBS screening are as follows: First, the screening methods. Screening sensitivity and specificity are key concerns; the screening methods traditionally used… It is the traditional bacterial culture method; however, conventional bacterial culture is time-consuming and has a high false-positive rate. Currently, both domestically and internationally, significant advances have been made in improving bacterial culture techniques. , showing significant improvements in both sensitivity and specificity, and has also been recommended by the U.S. CDC. Second, the variability of vaginal microbial species and colonies—for example, at 35 weeks or later— Early test results are negative, but GBS infection may still occur before delivery, leading to neonatal infection during labor; third, despite the administration of prophylactic treatment… In the management of GBS infection, neonatal morbidity and mortality remain high, owing to factors such as improper implementation of intrapartum antibiotic prophylaxis and antibiotic resistance. The question of how to administer prophylactic treatment, as well as preventive measures… Can treatment truly reduce the incidence of neonatal infections and mortality caused by GBS? At present, there are no definitive research data or evidence‑based medical evidence available in China on this issue. There are few relevant studies or articles with statistical value. Therefore, whether GBS infection screening is warranted in China remains an issue that requires further investigation. However, in the face of… China’s large patient population raises critical questions regarding the widespread implementation of screening and preventive therapies, as well as the need to avoid overtreatment.

Reporter ： Professor Zou, your analysis is extremely detailed and comprehensive. Based on your many years of clinical experience, how should preventive treatment be approached?

Professor Zou Li: Preventive treatment for GBS is very straightforward—antibiotic therapy. The recommended antibiotic regimen for preventing GBS disease is penicillin G, with an initial dose of 5 million units. Intravenous administration, followed by 2.5 million units intravenously every 4 hours; or an initial bolus of 2 g ampicillin intravenously, followed by 1 g intravenously every 4 hours. Until delivery. If there is a drug allergy, clindamycin or erythromycin-based agents may be substituted; these are also effective. Using this approach, approximately 18.3% of parturients require… Prophylactic treatment can prevent 68.8% of early-onset GBS infections in newborns.