Group B Strep is the most common cause of life-threatening infection in newborn babies. New guidelines from the Royal College of Obstetricians and Gynaecologists seek to implement better preventative measures.
Group B Strep (GBS) is a bacterium frequently carried in the vagina and the most common cause of life-threatening infection in newborn babies. In particular GBS infections are known to cause meningitis, sepsis and pneumonia and may result in serve disability(including brain damage) or death.
Women who carry the bacteria will usually be unaware of it and their pregnancy may continue without any symptoms or complications. However, once the mother’s waters have broken (i.e. the protective membrane has ruptured) GBS bacteria in the lower vaginal tract can be passed to baby during vaginal delivery.
Once diagnosed, a neonatal GBS infection needs to be treated quickly and aggressively to maximise the chances of a full recovery. However, the transfer of these infections from mother to baby could be relatively easily prevented with antenatal screening and treatment.
GBS bacteria can be readily detected through screening tests such as sensitive Enriched Culture Medium (ECM) testing. Unfortunately this screening is not currently available to the majority of expectant mothers on the NHS and it is not standard practice to screen women for GBS.
The current mortality rate from infection is 2-3% for babies born at term, but as high as 20-30% for babies born before 37 weeks. The Royal College of Obstetricians and Gynaecologists (RCOG) are therefore advocating changes to protect babies born prematurely (i.e. before 37 weeks) who are likely to be at greater risk from infection.
Currently antibiotic prophylaxis to prevent infection is not usually given to women in labour until 24 hours after their waters have broken. The RCOG suggest that any woman who goes into labour before 37 weeks should be offered antibiotics as a precaution, even if her waters have not broken and the protective amniotic sac/membrane surrounding the baby remains is intact. In addition, it is recommended that any mothers who have been tested positive for GBS in a previous pregnancy should be screened at 35 to 37 weeks in subsequent pregnancies to see if they are likely to require antibiotics in labour.
Whilst the RCOG recommendations are to be welcomed for the protective and preventative measures they introduce, they fall short of advocating routine screening for all mothers-to-be. This is disappointing given the relatively low cost of screening tests for GBS bacteria and the potentially life threatening consequences of such infections.
If you are pregnant and are concerned about the risk of GBS infection then speak to your doctor or midwife. If they are unable to provide you with testing on the NHS, then it is possible to arrange for testing to be done privately. Further information on private testing can also be found here: http://gbss.org.uk/information-and-support/testing-for-gbs/ecm-test-where-how/
Alternatively, if you have concerns regarding treatment provided for a maternal or newborn infection, or consider that any other aspect of the care you or a family member received during pregnancy and labour may have resulted in an injury to mother or child, then please contact Carolyn Lowe (firstname.lastname@example.org / 01865 781019) or Catherine Bell (email@example.com / 01865 781140) for a free confidential discussion.
Group B Strep Support would like every pregnant woman to be offered the opportunity to be tested for the bacteria. Chief executive Jane Plumb said: "The RCOG guideline is a significant improvement on previous editions, however, the UK National Screening Committee still recommends against offering GBS screening to all pregnant women, ignoring international evidence that shows such screening reduces GBS infection, disability and death in newborn babies."