Published: July 08, 2008 01:25 pm            

Group B strep infection during pregnancy

Group B streptococcus (GBS) is a common bacteria present in the reproductive, urinary, and digestive tracts of men and women. In women with GBS, the bacteria are most commonly found in the vagina and rectum.

Adults with GBS do not usually develop an illness. However, GBS infection can lead to infections of the urinary tract, blood-stream, skin and soft tissue, or bones and joints; pneumonia; and rarely meningitis.

Newborns and infants are most at risk of sickness or death from a GBS infection. Infants with GBS may develop infections of the blood, lungs, brain, or spinal cord. These illnesses are fatal in about 5% of infected babies. Roughly 10% to 30% of pregnant women are GBS carriers.

A mother with GBS can pass it to her newborn during delivery. One or two percent of infants born to mothers with GBS will become infected, and infants born to black women, Hispanic women, and women younger than 20 have a higher risk.

Many GBS infections occur between six hours and seven days of birth. Infections can also develop after the first week of life—about half of these are transmitted during delivery, and the other half occur when an infant comes in contact with an adult who is a GBS carrier.

Because GBS is usually passed during vaginal delivery, ACOG recommends that all pregnant women be tested for the bacteria between 35 and 37 weeks of pregnancy. To screen for GBS, your doctor will collect vaginal and rectal swabs that will be sent to a lab for analysis.

If you test positive, you will be given antibiotics just before delivery (usually penicillin unless you are allergic). Antibiotics are only given during labor because of the speed that the bacteria grow—if GBS is treated earlier during pregnancy, the bacteria may return by the time you deliver your baby.

If you have previously had an infant with GBS, if your water breaks more than 18 hours before delivery, or if your water breaks before labor begins, you may be given antibiotics to treat GBS even if you have not been previously tested for it.

The risk of GBS transmission is extremely low with cesarean delivery. However, women who will deliver by planned cesarean should still be screened for GBS in case a vaginal delivery becomes necessary. Antibiotics will not be needed if the scheduled cesarean goes as planned.

For more information, the ACOG Patient Education Pamphlet “Group B Streptococcus and Pregnancy” is available in English and Spanish at www.acog.org/publications/

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