How to Protect Your Baby From Group B Strep

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Group B Streptococcus (GBS), also known as beta strep or group B strep, is a type of bacteria that lives in the human body.  GBS is usually harmless. In fact, you can have GBS and not know it because you don't feel sick or have symptoms of an infection.

However, if you plan to get pregnant, you need to know if you are a GBS carrier. If you pass GBS to your baby during childbirth, it could make them very sick.

Here's what you need to know about how GBS is diagnosed and treated during pregnancy and labor, as well as how you can protect your baby after birth.

Misconceptions About Group B Strep

There are a few common misunderstandings about Group B strep, including how it is transmitted and the type of illness it causes.

  • Group B strep is not an infection that you get through sexual activity, by sharing food or drinks, or through touching objects that have GBS bacteria on them.
  • Group B strep is not passed through breastmilk; a person with GBS can safely breastfeed their baby if they choose to do so.
  • Group B strep is not the same as the bacteria that causes strep throat (Group A strep).
  • Group B strep is found in the human body, especially the intestinal and genital tracts. It does not usually cause illness.
  • Group B strep that invades other parts of the body (such as the lungs, brain, or blood) can make a person very sick; this is called GBS disease.

Testing for Group B Strep

Group B strep can be in your body at any time, but it might not be in your body all the time. You might test positive at some points during your pregnancy and not at others. That's why you will need to be tested when you are close to delivering because that's when your baby is at the highest risk for infection.

Babies can come into contact with group B strep bacteria as they pass through the vagina during birth. Getting diagnosed with GBS and treated with intravenous (IV) antibiotics while you are in labor reduces the risk of passing the infection to your baby from one in 200 to one in 4,000.

According to the American College of Obstetricians and Gynecologists (ACOG), GBS is passed to a baby in 1 to 2 out of every 100 deliveries where a person who tests positive does not receive antibiotics during labor.

The Centers for Disease Control and Prevention (CDC) recommends that pregnant people are tested for GBS at 35 to 37 weeks. For the test, a sterile swab is used to collect a sample from the vagina and rectum. Then, the sample is sent to the lab and cultured to see if group B bacteria grow. The process can take a few days, which means the results are not immediate.

If a baby shows signs of GBS, testing them will require a sample of blood or spinal fluid.

Risk Factors

If you have certain symptoms or risk factors, you will be given IV antibiotics during labor even if you were not tested for GBS.

  • GBS was detected in your urine at any point during your pregnancy
  • You had a previous baby with GBS
  • You tested positive for GBS in a previous pregnancy
  • Your GBS status is not known
  • You go into labor before 37 weeks
  • You have a fever of 100.4 or higher during labor
  • Your water has been broken for longer than 18 hours

Should You Have a C-Section If You Are GBS Positive?

Experts do not recommend having a cesarean section (C-section) solely because you tested positive for GBS. If you are having a planned C-section, you will receive antibiotics as part of the surgery and won't need additional antibiotics if you have GBS.

You should still get tested for GBS even if you are having a C-section. It will be important for your healthcare team to know if you are positive for GBS in case you go into labor and deliver before your scheduled procedure.

GBS Complications in Newborns

GBS infection can cause inflammation of a baby's lungs, spinal cord, or brain. These infections can cause hearing or vision loss. GBS is also associated with cerebral palsy. If there are complications from the infection, such as sepsis or pneumonia, GBS can be deadly.

According to the CDC, 4% to 6% of babies with GBS will die. Early infections are more likely to be fatal than late infections.

Symptoms

Babies who have GBS will have symptoms that are similar to other (more common) conditions or infections. If your baby is known to be at risk for GBS, your healthcare providers will monitor them for signs and symptoms of an infection.

Signs and symptoms that could indicate GBS include:

  • Fever
  • Poor feeding
  • Lethargy or "limpness"
  • Fussiness, irritability
  • Hard to wake up from sleep
  • Trouble breathing, fast breathing, or periods of not breathing
  • Changes in blood pressure
  • Seizures or convulsions
  • Moving one or more limbs less often
  • Areas of red skin on the body
  • Blue tint to the skin (cyanosis)

Early vs. Late Infection

Early GBS infections tend to occur within the first 48 hours after birth but can occur up to seven days after delivery. Early infection can be prevented with antibiotics given during labor. Babies with early-onset GBS typically have symptoms shortly after birth.

Late GBS infections develop after the first week of life and are not prevented by antibiotics that are given during labor. Babies with late-onset GBS often are healthy at birth and develop symptoms later.

The rates of early- and late-onset GBS are similar. According to data from the Centers for Disease Control and Prevention (CDC) about 930 babies get early-onset GBS each year and about 1,050 babies get late-onset GBS.

The main concern for babies with late GBS is meningitis, an infection that causes inflammation in the brain and nervous system.

While early infections arise from exposure during delivery, late infections are not always acquired at birth. In fact, half of them come from other sources—such as contact with people in the hospital or at home who are GBS carriers.

Penicillin (given through an IV instead of a pill taken by mouth) is the main antibiotic given to prevent early GBS.

What You Can Do

The most important thing you can do to protect your baby is get tested for GBS while you are pregnant and, if you are positive, receive antibiotics during your labor.

Some babies get GBS even if antibiotics were given during labor. Scientists are not sure why this occurs, but they are working on developing better ways to treat—and even vaccines to prevent—GBS.

There are no additional steps that you can take to specifically protect your baby from GBS once they are born. The most important thing you can do is learn the signs and symptoms of GBS infection and know how to recognize them. If you have any concerns about GBS or think your baby might be showing signs of the infection, contact your provider right away.

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Article Sources
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  1. Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. GBS: Types of Infection. Updated May 21, 2019.

  2. Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. GBS: Prevention in newborns. Updated July 16, 2020.

  3. Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. GBS: Fast facts and statistics. Updated June 11, 2020.

  4. American College of Obstetricians and Gynecologists (ACOG). Group B Strep and pregnancy. Updated July 2019.

  5. Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. GBS: Diagnosis, treatment, and complications. Updated May 21, 2019.

  6. World Health Organization (WHO). Group B Streptococcus infection causes an estimated 150,000 preventable stillbirths and infant deaths every year. Updated November 6, 2017.

  7. Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases, Division of Bacterial Diseases. GBS: Signs and symptoms. Updated May 17, 2019.

  8. Cedars-Sinai. Group B Streptococcus Infection in babies.

  9. American College of Obstetricians and Gynecologists (ACOG). Prevention of group B Streptococcal early-onset disease in newborns. Updated February 2020.

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