By Richard N. Waldman, MD
President, The American Congress of Obstetricians and Gynecologists
Group B streptococcus (GBS) is a common bacteria present in the reproductive, urinary, and digestive tracts of men and women. Though GBS can lead to certain infections (such as urinary tract, blood-stream, skin and soft tissue, or bones and joints, pneumonia, and rarely meningitis in adults), most people with GBS do not develop an illness.
The risk of sickness or death from a GBS infection, although exceedingly rare, is much higher in newborns and infants. GBS can cause infections of the blood, lungs, brain, or spinal cord in newborns and is fatal in about 5% of babies who carry it. Many GBS infections occur between six hours and seven days of birth, though late-onset infections can develop after the first week of life.
Because the infection is usually passed during vaginal delivery, stopping mother-to-child transmission is key. An estimated 10%–30% of pregnant women are infected with GBS and up to 2% will transmit it to their newborns. Infants born to black women, Hispanic women, and women younger than 20 are at increased risk.
The American College of Obstetricians and Gynecologists recommends that all pregnant women be tested for GBS between 35 and 37 weeks of pregnancy. Vaginal and rectal swabs are used to collect samples that will be sent to a lab for analysis.
Women who test positive, will be treated with antibiotics just before delivery (usually penicillin unless an allergy exists). Antibiotics are only given during labor. If GBS is treated earlier during pregnancy, the bacteria may return by the time of delivery.
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 between 35 and 37 weeks of pregnancy in case a vaginal delivery becomes necessary. Antibiotics will not be needed if the scheduled cesarean goes as planned.
Antibiotics do not treat late-onset GBS infections in infants. Contact your pediatrician if your baby is slow or inactive, irritable, feeding poorly, vomiting, or has a high fever.
For more information, the ACOG Patient Education Pamphlet “Group B Streptococcus and Pregnancy” is available in English and Spanish at www.acog.org/publications/patient_education .?
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