{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T14:32:46Z","timestamp":1791988366672,"version":"4.4.0"},"reference-count":65,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2012,1,18]],"date-time":"2012-01-18T00:00:00Z","timestamp":1326844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic> Berger M, Xu X, Williams J, Van de Ven C, Mozurkewich E. Early hospital discharge of infants born to group B streptococci\u2010positive mothers: a decision analysis. BJOG 2012;119:439\u2013448.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> To compare the cost\u2010effectiveness of an additional 24\u2010hour inpatient observation for asymptomatic term neonates born to group B streptococcus (GBS) \u2010colonised mothers with adequate intrapartum antibiotic prophylaxis (IAP) after an initial 24\u2010hour in\u2010hospital observation.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Cost\u2010effectiveness analysis from a societal perspective.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> United States.<\/jats:p><jats:p><jats:bold>Population\u2002<\/jats:bold> Asymptomatic term neonates born to GBS\u2010colonised mothers with IAP after an initial 24\u2010hour in\u2010hospital observation.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Monte Carlo simulation for a decision tree model incorporating the following chance events: development of GBS sepsis during the second 24\u2003hours of life, development of GBS sepsis between 48\u2003hours and 7\u2003days of life, prompt versus delayed treatment for sepsis, neonatal mortality and long\u2010term health sequelae.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Expected cost and quality\u2010adjusted life years (QALYs), Incremental cost\u2010effectiveness ratio (ICER).<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> Delayed, versus early, hospital discharge results in similar mean expected QALYs, but substantially higher expected cost. The mean difference in QALY is 0.00016 (95% CI 0.00005\u20130.00040), whereas the mean difference in cost is $1170.96 (95% CI $750.13\u20131584.32). The ICER is estimated to be $9,771,520.87 per QALY (95% CI $2,573,139.89\u201324,407,017.82). The proportion of early\u2010onset GBS that develops during the second 24\u2003hours of life, the cost of 24\u2003hours of inpatient observation, and the probability of long\u2010term sequelae following prompt versus delayed treatment play important roles in determining the cost\u2010effectiveness of delayed hospital discharge.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Cost\u2010effectiveness analysis suggests that with adequate IAP, discharging asymptomatic term neonates to home after 24\u2003hours is the preferred approach compared with 48\u2003hours inpatient observation.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2011.03249.x","type":"journal-article","created":{"date-parts":[[2012,1,18]],"date-time":"2012-01-18T10:28:28Z","timestamp":1326882508000},"page":"439-448","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Early hospital discharge of infants born to group B streptococci\u2010positive mothers: a decision analysis"],"prefix":"10.1111","volume":"119","author":[{"given":"MB","family":"Berger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JA","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"CJM","family":"Van de Ven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EL","family":"Mozurkewich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,18]]},"reference":[{"key":"e_1_2_11_2_2","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease: a public health perspective. 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