Do you know about group B Strep?
Expecting a baby can be one of the best times of your life. It’s a time when it’s important to know about group B Streptococcus (group B Strep/GBS) as it is the most common cause of severe infection in newborn babies.
What is GBS?
GBS is a common bacterium which is present in the intestines of up to one in every three adults and in the vagina of approximately one in every four women. Carrying it has no symptoms and whilst GBS does not cause infections in healthy people, it can affect new born babies. Carrying GBS around the time of giving birth is recognised as an important risk factor for severe infection in newborn babies, yet women in the UK are rarely told about it by their health professionals and even more rarely offered testing.
Many babies are exposed to GBS without any ill effects but some are susceptible to the bacteria and develop infection. When GBS gets into the bloodstream or lungs of a newborn baby, it can cause infections such as sepsis and pneumonia. Most GBS infections in babies develop within the first few hours of life (called early onset GBS infection) and, less commonly, it can develop up to the age of three months (late onset GBS infection). Late onset GBS infections are more likely to include meningitis, with many of the survivors suffering life-long disabilities.
Most GBS infection in newborn babies can be prevented by identifying which babies are at higher risk and giving the mums-to-be intravenous antibiotics during labour.
How do women know if they have GBS?
GBS colonises the intestines of around a third of humans with no symptoms at all; it is a normal body commensal (usually harmless bacteria or other organisms that normally live in or on the body. GBS normally cause no harm or symptoms to the carrier and therefore colonisation may be intermittent. In women, the bacteria often colonises the vagina.
The method used for GBS detection is critical for obtaining accurate results for GBS carriage. When done properly, antenatal GBS screening can give a very good indication as to the carriage status of the mother at delivery.
Testing for GBS is not routinely offered in the UK and many NHS hospitals don’t have access to the sensitive ‘gold standard’ ECM (Enriched Culture Medium) tests for GBS carriage. ECM tests are available from a number of NHS Trusts, plus privately at clinics and through home-testing packs which cost around £35 each. For availability, see www.gbss.org.uk/test.
To predict with greater accuracy the chances of carrying GBS at delivery, the best time to test is at between 35 and 37 weeks of pregnancy using a vaginal and rectal swab. Testing later than 37 weeks increases the chance that the baby will be born before the result is available.
Many more GBS infections in newborn babies could be prevented by offering all pregnant women the sensitive ‘gold standard’ ECM test and offering intravenous antibiotics to those carrying GBS to prevent the infection occurring in the newborn baby.
What else should I know?
A baby is more likely to develop GBS infection when:
- Mum has previously had a baby who had GBS infection
- GBS is found in Mum’s urine or on a swab this pregnancy
- Mum has a high temperature in labour
- Labour starts or waters break before 37 completed weeks of pregnancy
- Waters break more than 18 hours before the baby is born
If GBS is found in the urine during pregnancy, Mum will be given oral antibiotics to clear the infection. She will also be offered intravenous antibiotics in labour against GBS infection developing in her baby. The use of antibiotics at this stage reduces the risk of GBS infection in the newborns from around a one in 300 risk to less than one in 6,000.
If GBS has only been found from a vaginal or rectal swab, antibiotics aren’t given as they’re not beneficial during pregnancy until labour starts, when they should be offered.
What does charity Group B Strep Support want to see?
Group B Strep Support (www.gbss.org.uk), founded in 1996, is the UK’s only charity focussed on GBS infection in newborn babies – promoting greater awareness and improving prevention of these usually avoidable but potentially life-threatening infections. The Charity campaigns for pregnant women to be fully informed about GBS during routine antenatal care and for GBS-specific testing to be freely available.
Group B Strep Support wants:
- Every pregnant woman to be given information on GBS as a routine part of antenatal care.
- Every pregnant woman whose baby is at low-risk of developing GBS infection to be offered an ECM test for GBS carriage at 35-7 weeks of pregnancy (and where these are not available from the hospital, the women should be told how to access them privately)
- Every pregnant woman whose baby is at higher risk of developing GBS infection (where one or more of the risk factors listed above are present) to be offered intravenous antibiotics from the start of labour until birth and, where the babies are at highest risk, for these antibiotics to be recommended.
Jane Plumb MBE, Group B Strep Support’s Chief Executive, says, “We believe this is the best approach for preventing GBS infection in newborn babies in the UK. It is so important that pregnant women are informed about GBS and consider testing.”
Group B Strep Support campaigns for greater awareness and better prevention of GBS infection in newborn babies, including offering the simple and safe ‘Gold Standard’ ECM test to every pregnant mum.
Jane Plumb MBE adds, “Sadly, we continue to hear from and offer information and support to families who have suffered as a result of GBS. As one mother put it, “I can’t explain the pain; it’s not something that I could ever imagine feeling ever again. I don’t know anything that compares.”
Sarah Jane Chapman has created a petition, ending on 31 December 2013, asking The Department of Health to ensure women are routinely offered testing for group B Strep in every pregnancy. Please read it at http://epetitions.direct.gov.uk/petitions/43712 and consider signing it, and sharing it with your friends and family.
July is GBS Awareness Month – A Simple Test to Save a Life – and Group B Strep Support will be urging pregnant women to get informed about GBS and consider testing.
For further information about group B Strep, visit the Group B Strep Support website at www.gbss.org.uk or call 01444 416176.