Summary WHO_recommendation_on_Screening_of_pregnant_women_for_intrapartum

WHO recommendation on Screening of pregnant women for intrapartum antibiotic prophylaxis for the prevention of early onset Group B streptococcus disease in newborns WHO recommendation on Screening of pregnant women for intrapartum antibiotic prophylaxis for the prevention of early onset Group B streptococcus disease in newborns WHO recommendation on screening of pregnant women for intrapartum antibiotic prophylaxis for the prevention of early onset Group B streptococcus disease in newborns ISBN 978-92-4-009912-8 (electronic version) ISBN 978-92-4-009913-5 (print version) © World Health Organization 2024 Some rights reserved. This work is available under the Creative Commons Attribution- NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. 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The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. iii Contents Acknowledgements v Acronyms and abbreviations vi Executive summary vii 1. Introduction 1 1.1 Background 1 1.2 Rationale and objectives 2 1.3 Target audience 2 1.4 Scope of the recommendation 2 1.5 Persons affected by the recommendation 2 2. Methods 3 2.1 Contributors to the guideline 3 2.2 Identification of priority questions and outcomes 5 2.3 Evidence identification and retrieval 5 2.4 Certainty assessment and grading of the evidence 5 2.5 Formulation of the recommendation 6 2.6 Management of declarations of interests 8 2.7 Decision-making during the GDG meetings 9 2.8 Document preparation 9 2.9 Peer review 9 3. Guiding principles, recommendations and supporting evidence 10 3.1 Guiding Principles 10 3.2 Recommendation and supporting evidence 11 4. Dissemination, adaptation and implementation of the recommendation 13 4.1 Recommendation dissemination 13 4.2 Adaptation 13 4.3 Implementation considerations 13 5. Research gaps 15 6. Applicability issues 16 6.1. Anticipated impact on the organization of care and resources 16 6.2. Monitoring and evaluating guideline implementation 16 7. Updating the recommendations 17 8. References 18 Annex 1. Contributors to the recommendation 21 Annex 2. Priority outcomes used in decision-making 24 Annex 3. Summary and management of declared interests from GDG members 25 Annex 4. Evidence-to-Decision Frameworks 26 Framework 1: Screening strategies compared with no screening strategies 26 Framework 2: Screening strategies compared with other screening strategies 55 v Acknowledgements Acknowledgements The World Health Organization (WHO) Department of Sexual and Reproductive Health and Research (SRH) and Department of Maternal, Newborn, Child and Adolescent Health and Ageing (MCA) gratefully acknowledge the contributions of many individuals and organizations in the development of this recommendation. Work on this recommendation was initiated by the WHO SRH Department. This guideline was coordinated by Mercedes Bonet, Doris Chou, Tina Lavin and Olufemi Oladapo (SRH), as well as Karen Edmond (MCA). WHO extends its sincere thanks to Felix Achana (University of Oxford, United Kingdom of Great Britain and Northern Ireland), Subha Sri Balakrishnan (CommonHealth, India), Maria Laura Costa (State University of Campinas, Brazil), Hadiza Galadanci (Bayero University, Nigeria), Caroline Homer (Burnet Institute, Australia), Mary Kinney (University of the Western Cape, South Africa), Samantha Lissauer (Malawi Liverpool Wellcome Clinical Research Programme, Malawi), Hiromi Obara (National Center for Global Health and Medicine, Japan), Alfred Osoti (University of Nairobi, Kenya), Kristine Russell (Sepsis Canada, Canada), Sadia Shakoor (The Aga Khan University, Pakistan) and M. Jeeva Sankar (All India Institute of Medical Science, India) who served as members of the Guideline Development Group (GDG), and to Ashraf Nabhan (Ain Shams University, Egypt) (chairperson) for leading the meeting. We also thank Ayse Akin (Baskent University, Türkiye), Shabina Ariff (The Aga Khan University, Pakistan), Michel Boulvain (Geneva University Hospitals, Switzerland), Christine East (La Trobe University, Australia), Jeganathan Ravichandran (Ministry of Health, Malaysia) and Priya Soma-Pillay (University of Pretoria, South Africa) who were members of the External Review Group (ERG). WHO also gratefully acknowledges the contribution of the members of the Executive Guideline Steering Group (GSG). Connor Allen (Monash University, Australia), Susan Ayers (City, University of London, the United Kingdom), Vincent Bekker (Leiden University, Kingdom of the Netherlands), Georgina Constantinou (City, University of London, the United Kingdom), Timothy Panneflek (Leiden University, Kingdom of the Netherlands), Thomas van den Akker (Leiden University, Kingdom of the Netherlands) and Rebecca Webb (City, University of London, the United Kingdom) produced the systematic reviews that provided the evidence base for this recommendation. Mónica Chamillard and Virginia Diaz (Centro Rosarino de Estudios Perinatales, Argentina) reviewed the effectiveness evidence and prepared the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tables. Aleena Wojcieszek (Dr Aleena Wojcieszek Consulting, Australia) reviewed the evidence profiles and, with members of the ESG and WHO Steering Group, prepared the corresponding narrative summaries and evidenceto- decision frameworks. Mercedes Bonet, Tina Lavin and Aleena Wojcieszek drafted the final guideline document, before it was reviewed by the WHO Steering Group, GDG and ERG. The ERG peer reviewed the final document prior to executive clearance by WHO and publication. We acknowledge the organizations that were represented by observers, including Meridith Mikulich (United States Agency for International Development [USAID]), Jeffrey Smith (Bill & Melinda Gates Foundation) and Bo Jacobsson (International Federation of Gynaecology and Obstetrics). We also appreciate the contributions of staff at the WHO regional offices, including Bremen de Mucio (Regional Office for the Americas), Karima Gholbzouri (Regional Office for the Eastern Mediterranean) and Delgermaa Vanya (Regional Office for the Western Pacific). WHO acknowledges the financial support for this work received from USAID and the UNDP– UNFPA–UNICEF–WHO–World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research. WHO emphasizes that donors do not participate in any decision related to the guideline development process, including the composition of research questions, membership of the guideline development groups, conducting and interpretation of systematic reviews, or formulation of recommendations. The views of the funding bodies have not influenced the content of this recommendation