Challenges and opportunities of universal culture-based Group B streptococcus screening in Hong Kong -- a retrospective cross-sectional study
Bibliographic record
Abstract
Objective: To evaluate gaps in universal Group B Streptococcus (GBS) screening and intrapartum antibiotic prophylaxis (IAP) in Hong Kong after its 2012 implementation, which reduced early-onset GBS disease (EOGBSD) incidence from 1.03 to 0.26 per 1000 live births. Design: Retrospective cross-sectional study. Setting: Eight Hospital Authority obstetric units and thirty-one Department of Health Maternal Child Health Centers (MCHCs), Hong Kong. Population: EOGBSD cases (2012–2022) and their mothers. Methods: Cases were electronically identified; maternal and neonatal records were reviewed for screening adherence, IAP administration, and delivery timing. Main Outcome Measures: EOGBSD incidence, screening gaps (missed tests, delayed results, prolonged screening-to-delivery intervals), and IAP compliance. Results: Among 72 EOGBSD cases, 53 eligible mothers were analyzed: 3 missed screening, 8 lacked results at delivery, and 7 delivered >5 weeks post-screening. Of 17 preterm deliveries, 41% (n=7) received no IAP due to precipitous labor (n=3), prelabor cesarean (n=3), or birth before arrival (n=1). Six neonatal deaths occurred. Conclusions: Despite successful EOGBSD reduction, critical gaps persist, including missed screenings, results unavailable at delivery, and deliveries beyond the 5-week screening validity window. Revising local protocols to address prolonged screening-to-delivery intervals and standardizing management for mothers with unknown GBS status could further reduce EOGBSD. Increased awareness and optimized workflows for preterm deliveries are needed. Keywords: Streptococcus agalactiae ; Pregnancy; Antibiotic prophylaxis; Prenatal screening; Neonatal sepsis
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".