The first story I read was heartbreaking. A mother-to-be at 38 weeks, in for a routine prenatal appointment. The heartbeat check turns up nothing. The baby has died, and she must undergo induction for a stillbirth. Weeks later, she learns that her baby tested positive for a Group B Streptococcus (group B strep or GBS) infection of the blood and lungs. The mother had tested positive for GBS in a previous visit, but because her membranes were intact, no one was concerned.
GBS is present in about 25% of pregnant women. According to the Centers for Disease Control and Prevention (CDC), this bacteria is the most common cause of life-threatening infection in newborns. Many women undergoing standard prenatal care also undergo testing for GBS. They can carry the bacteria in the vagina or rectum without having any symptoms, but if the bacteria pass to the womb, the outcome can be devastating.
The disease in infants can be early-onset or late. Early-onset disease afflicts newborns in the first week, most commonly causing a blood infection (sepsis) or lung infection (pneumonia), although meningitis (inflammation of the brain membranes) can also happen. Late-onset disease, in which meningitis is more common, occurs from the second week through the first three months of life. Early-onset GBS infection afflicts about 1200 babies each year in the United States, with outcomes that can vary from permanent deficits such as deafness and developmental disabilities to death. In many cases, detection and treatment can prevent transmission from mother to child.
July is GBS Awareness Month. Pregnant women, parents of newborns, and healthcare providers should be aware of the following to help prevent the possible devastating outcomes of infant GBS infection:
- The CDC recommends that all pregnant women be screened for GBS in weeks 35 to 37.
- The standard test is a painless vaginal and rectal swab test.
- A rapid DNA test is also available in some places.
- A woman should be tested in each pregnancy.
- A positive test requires follow-up, awareness, and treatment.
- Treatment consists of antibiotic administration, often during labor.
- Transmission usually occurs during passage through the birth canal but can occur before birth.
- Risk factors for early-onset GBS (during the first newborn week) include early delivery, urine positive for GBS during pregnancy, fever during labor, and a long period between water breaking and delivery.
- GBS infection in infants occurs at higher rates among African-Americans than other ethnic groups.
- If an infant has fever, difficulty feeding, irritability or lethargy, difficulty breathing, or a bluish color to the skin, contact a healthcare provider immediately or go to an emergency room.
It’s important to note that GBS is not a sexually transmitted disease. These bacteria are simply often present in the digestive tract or the vagina or rectum of about 25% of women. A healthy adult carrier would likely never even notice their presence. That’s one reason the CDC shifted its guidelines from testing only pregnant women who had risk factors to testing all pregnant women. It’s another quick and straightforward way to prevent infection and death in infants.
For more information about GBS testing or to learn more about promoting July as GBS Awareness Month, visit Group B Strep International, an organization founded by parents of children who were born stillborn, full term, because of GBS infection. And remember…getting tested isn’t the only step in preventing GBS transmission from mother to child.
Image courtesy of tostadophoto.com