Self-collection of antepartum anogenital group B streptococcus cultures

Abstract

Background: Group B streptococcus (GBS) from the maternal perineum is a leading cause of serious neonatal infection. Recommendations by the Centers for Disease Control and Prevention include cultures from anogenital swabs on all pregnant women between 35 and 37 weeks' gestation. This study examines whether a significant difference in test results exists between GBS cultures from swabs done by physicians and those done by patients, and whether patients prefer to perform the swab themselves, with the potential of enhancing patient satisfaction and decreasing utilization of health care resources. Methods: Study design was a comparison of 250 obstetrics patients attending a military community hospital family medicine clinic. Patients were assigned on an alternating basis to perform an anogenital culture swab before or after the physician performed a swab. Patients were designated to complete a preference survey before or after the swabs were performed. Descriptive statistics, chi square, and Mc-Nemar's test corrected for multiple comparisons, and the Kruskal-Wallis test on effect of order on test outcome were used to analyze the data. Results: Forty-two of 250 patients had positive cultures. There was no statistically significant difference between swab results done by patients and those done by physicians. There was no significant difference between results of first swabs and results of second swabs. Of the 250 patients 145 preferred self-collection. There was no statistically significant relation between preference and order of completion of the questionnaire. Conclusions: Patient-collection technique is as accurate as physician collection. A majority of patients in this study population preferred self-collection of GBS swabs.