OB update from Dr. Hall-Minnie–Protecting Your Baby Against Group B Strep

mom and newborn just after deliveryGroup B Streptococcus (Group B strep or GBS) is a type of bacteria that can cause illness in people of all ages. In newborns, the effect of Group B Strep infection can be very serious. It can cause meningitis (infection of the spinal fluid and lining around the brain), pneumonia (lung infection), and sepsis (blood infection). We want our pregnant patients to understand the recommendations that will help protect your baby from this illness. Obstetricians have followed these recommendations for many years, and we have been very successful in making early-onset newborn infection a rare event. The message here is—we want you to understand, but not to worry!

Group B strep infection is NOT caused by the same bacteria that causes “strep throat.” (That is streptococcus group A). Group B Strep is also NOT a sexually transmitted disease. We all carry Group B strep in the digestive tract. At any given time, about 25% of pregnant women carry the bacteria on the skin around the vagina and rectum. The bacteria usually cause no symptoms and may come and go from the body. So, whether you are among the 25% can change from month to month. If you carry the bacteria around the birth canal when you go into labor, you may pass the infection to your baby. Because our newborn intensive care units are able to support very sick newborns, most babies with GBS infections survive, but some may still have long-term complications like hearing loss or developmental disabilities.

Fortunately, even among women who test positive for the bacteria, most babies are unaffected. Premature infants have the highest risk of GBS disease. We treat all women in pre-term labor with antibiotics to reduce the risk to their infants.  Full-term babies have very low risk of infection (about 1 in 800, without preventive treatment). Following the guidelines below reduces the risk to about 1 in 4000. Here is the procedure we follow to protect your baby:

  • Between the 35th and 37th week, we test our pregnant patients planning a vaginal delivery for Group B Strep. The test involves taking a swab of the vaginal and rectal tissue and sending the swab to the laboratory to test for Group B streptococcus. You should let your doctor know if you are allergic to penicillin so that the correct test can be ordered.
  • If you test positive, we will give you an IV (in the vein) antibiotic during labor.
  • If you have had GBS in your urine earlier in this pregnancy or if your baby became sick with GBS shortly after birth (a previous pregnancy), you will receive antibiotics during labor regardless of whether you are carrying the bacteria.
  • If a woman comes into labor not knowing whether she has been positive for Group B strep, she will receive antibiotics if she has any of the following risk factors:
    • She is less than 37 weeks pregnant.
    • Her membranes rupture (water breaks) 18 hours or more before the delivery.
    • She has a fever during labor.
    • A GBS test performed when she arrives in labor is positive.
    • During a previous pregnancy, she tested positive for GBS.

We want you to know your GBS status and understand the guidelines. If you unexpectedly go into labor away from our care, understanding that your caregivers away from home are also following these guidelines will give you peace of mind. Inform the caregivers if you are a Group B strep carrier, or if you have not yet been tested and do not know your status. Again, we want you to be well-informed and reassured.