Group B Streptococcus

What is Group B Streptococcus?

Group B Streptococcus (GBS, or group B strep) is a bacteria carried by updating I to 30% of people, but it doesn't usually cause harm or symptoms. In women, it is found in the intestine and vagina. It causes no problem in most pregnancies. In a small number of pregnancies, it infects the baby, usually just before or during labour, leading to serious illness.

Though it's rare, GBS is the most common cause of severe infection in newborns, particularly in the first week after birth.

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Could I be carrying GBS?

If you are carrying GBS you probably won't even know it. This is because there aren't usually any symptoms. You could discover that you have GBS by chance, when having a vaginal swab taken to check for something else. There is a test available for GBS, but it's not routinely carried out in pregnancy due to concerns about its reliability. 

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Pregnancy & GBS

Roughly 1 in 2,000 babies in the UK develops a GBS infection shortly after being born. Sadly, about 1 in 10 of these babies dies. It's a very rare event when a baby does not survive a GBS infection but sadly it does happen. 

It isn't known why some babies develop an infection and others don't. What is clear is that most GBS infections in newborn babies can be prevented. 

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Most pregnant women who carry GBS bacteria have healthy babies. However, there’s a small risk that GBS can pass to the baby during childbirth. 

Rarely, GBS infection in newborn babies can cause serious complications that can be life threatening.

Extremely rarely, GBS infection during pregnancy can also cause miscarriage, early (premature) labour or stillbirth.

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What Happens If I Have GBS?

When you go in to labour, if you are in a high-risk group (listed below) your doctor will give you antibiotics via a drip in your arm. This is to reduce the risk of your baby developing a GBS infection. These are given from the start of your labour, or from when your waters break, right up to your baby's birth. 

If you are given antibiotics, they will need to be taken at least two hours before your baby is born.

As always there are some risks and drawbacks taking antibiotics in labour for you & your child. Your doctor will discuss your case with you.

There are a number of factors that help to predict whether your baby is likely to develop a GBS infection. (If you carry GBS)

These include:

If you go into labour prematurely (before 37 weeks of pregnancy)

If your waters break 18 hours or more before you have your baby

If you have a fever of 38 degrees C or higher during labour

If you have previously had a baby infected with GBS

If you carry GBS in your vagina and/or rectum during your pregnancy

If GBS has been found in your urine during your pregnancy

Having a caesarean is not a method of preventing GBS infection in babies. This is because having a caesarean doesn't eliminate the risk of GBS being passed on to your baby. 

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What Happens After Birth?

If you don't fall into one of the high-risk groups & your had the drip for at least 2 hours before giving birth, your baby is unlikely to develop a GBS infection.

If your baby is at higher risk of developing a GBS infection once they are born, they will be examined by a paediatrician.

Several factors decide whether or not you or your baby are given antibiotics:

If both you and your baby are completely healthy, and you had full treatment with antibiotics during labour, you baby won't need antibiotics.

If you are both healthy, but you didn't have antibiotics during labour, your baby may be started on antibiotics until given the all-clear.

If you or your baby shows signs of a GBS infection, your baby should be started on antibiotics without delay.

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Doctors are still researching the best way to treat newborns at risk of a GBS infection. That's why you may or may not receive antibiotics as your treatment. It may also depend on your hospital's policy and your own circumstances.

You and baby might be treated with penicillin without any side effects. Side effects include a rash, diarrhoea and nausea. These are minor, though penicillin may affect the balance of bacteria in baby's tummy. 

If you are known to be allergic to penicillin you will be given another antibiotic instead, called clindamycin.

These side effects make some doctors wary about using antibiotics particularly for newborns. Some doctors prefer to wait for the first 12 hours after the birth before starting a course of antibiotics, in case there's no need.

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What Are The Signs Of A GBS Infection In My Baby?

GBS infections in babies would usually happen within seven days of birth (early onset), with 90% occurring within 24 hours of your babies birth.

Typical signs of early-onset GBS infection in babies include:

Grunting

Poor feeding

Lethargy (Tiredness)

Irritability

Low Blood Pressure

Abnormally high or low temperature

Abnormally high or low heart rate or breathing rate

GBS infections can also develop when a baby is seven or more days old (late-onset), though it's not common. 

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GBS bacteria can cause bacterial meningitis, though late onset infections tend to be less severe than early onset infections. Most babies respond well to treatment, though meningitis can leave some babies with long term problems. 

GBS infections in babies are rare after they're one month old and are virtually unheard-of once they're over three months old.

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Why isn't there a national screening programme for GBS?

There's conflicting evidence and differing views about whether a national screening programme for GBS would be effective. 

Many experts believe that a screening programme would do more harm than good. If antibiotics are used too widely, bacteria may become resistant to antibiotics in the future. And interventions in pregnancy when it's not necessary may also do more harm than good. 

However, the charity Group B Strep Support continues to campaign for a GBS national screening programme.

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I'm carrying GBS. What happens next?

If you have been affected by GBS in a previous pregnancy, or are carrying it in your current pregnancy, talk to your midwife or obstetrician. You can then discuss a birth plan that includes steps to protect your baby from the infection. 

If you have GBS in your current pregnancy, a hospital birth will be recommended, so you can have antibiotics if you need them. 

Your pregnancy will then be managed so your baby is as protected as possible.