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Group B Strep (GBS) is a normally harmless bacteria commonly found in the human digestive tract. But this little bug has a darker side: in pregnant women, it can migrate to vaginal region where it can cause serious complications in a newborn after a vaginal delivery. The Centers for Disease Control and Prevention recommends administering intravenous antibiotics during childbirth for at-risk patients. This ounce of prevention has reduced the prevalence of GBS infection 10-fold, and fewer than one in 3,500 babies now contracts this disease during labor.

Before women were regularly screened for GBS, nearly three newborns in 1,000 developed early onset GBS infections. A baby infected with GBS can have it in their blood (sepsis), lungs (pneumonia), skin (cellulitis) and around their brain (meningitis). Even today with excellent screening and treatment, a small number of babies will die each year as the result of neonatal Group B Strep infections. As a result, both obstetricians and pediatricians will want to know a mother’s GBS status at delivery and consider that status carefully when presented with an ill baby.

Infections in the short-term lead to hospitalization and possibly long-term disabilities. GBS remains a particular concern for pre-term babies, who generally don’t recover as quickly from serious infections.

Your doctor or midwife will test for GBS in the last few weeks of pregnancy using a painless rectal and vaginal swab. Results usually follow in a few days. Because levels of this bacteria vary throughout pregnancy, testing earlier doesn’t provide the clearest picture. If you test positive for GBS, your physician will most likely start you on antibiotics at least four hours before the baby is born. If labor proves to be a sprint rather than marathon, you don’t need to worry. In virtually all cases, the antibiotic will prevent infection.

Babies born by mother’s who are GBS positive but who are delivered by C-section without prior rupture of membranes (i.e. The water never broke) are at a lower risk of GBS infection.

These days, hospitals have a policy that they follow for babies born to GBS positive moms to decrease the risk of infection. If there is any doubt, the hospital will take a sample of your newborn’s blood to look for signs of infection. Newborns who develop GBS will usually begin to show symptoms within 24 hours, including irritability, fever, difficulty breathing, feeding problems, and temperature changes, among others. If your newborn shows no signs of infection after delivery, you can expect to take your newborn home on time.

Once you arrive home, you will monitor the baby for any signs of illness including fever (100.4 or greater), irritability, and poor feeding and seek medical attention for any concerns.

Takeaways

  •  Between 10-30 percent of pregnant women carry Group B Strep in their vagina.
  • GBS screening typically occurs during the 35th-37th week of pregnancy.
  • Risk factors include previous infections, high fevers, and when water breaks more than 18 hours before birth
  • Penicillin is the drug of choice for treating GBS, but other options do if exist for mothers with allergies

References

  1. Centers for Disease Control and Prevention. Prevention of Perinatal Group B Streptococcal Disease.

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