Group B strep: How to protect your baby

wamoGroup B strep can be dangerous for newborns. Here's what you need to know about group B strep — and why you need to be tested.

Group B streptococcus (group B strep) is a common bacterium often carried in the intestines or lower genital tract. Although group B strep is usually harmless in adults, it can be serious — even life-threatening — for newborns.

Having group B strep in your body is normal. There's nothing you can — or need — to do about it. But if you're pregnant, a group B strep screening test in the third trimester and antibiotic treatment during labor can help protect your baby.

Harmless in adults

Many adults have group B strep in their bodies, usually in the bowel, vagina, rectum or throat. In adults with serious medical conditions, such as liver failure or cancer, group B strep can cause dangerous infections. But most adults simply carry the bacterium, which means they have no symptoms and don't feel sick. In fact, group B strep in otherwise healthy adults isn't treated.

Pregnant women with group B strep are the exception. The bacteria can spread to a baby during a vaginal delivery if the baby is exposed to — or swallows — fluids containing group B strep.

Dangerous for babies

Most babies born to women carrying group B strep are born healthy. But the few who become infected can become critically ill. The risk is highest for premature babies.

In infants, group B strep disease can take two forms:

  • Early-onset. This is the more common and serious form of group B strep infection in infants. A baby with early-onset group B strep disease typically becomes sick within hours after birth. The infection usually starts with fever, difficulty feeding and lethargy. But it can lead to life-threatening complications, such as inflammation of the lungs (pneumonia), inflammation of the membranes and fluid surrounding the brain and spinal cord (meningitis), or infection in the bloodstream (sepsis).
  • Late-onset. Late-onset group B strep disease develops within a week to a few months after birth. Problems associated with late-onset group B strep disease can be similar to early-onset group B strep disease, but the impact is usually less severe.

Long-term effects of either type of group B strep disease may include seizures, hearing loss or other neurological damage — particularly following meningitis.

How to know if you have group B strep

Most cases of group B strep disease in infants can be prevented by screening and antibiotic treatment during labor. The Centers for Disease Control and Prevention (CDC) recommends group B strep screening for all pregnant women between weeks 35 and 37.

Your health care provider will send a swab from your vagina and rectum to a lab for testing. A positive test indicates that you carry group B strep. It doesn't mean that you're ill or that your baby will be affected. It simply means the potential for newborn infection exists.

How group B strep affects labor

You can have a vaginal delivery if you test positive for group B strep. To protect your baby, you'll be given an intravenous (IV) antibiotic — such as penicillin or ampicillin — when labor begins. If you're allergic to penicillin and related drugs, you may receive clindamycin or a similar alternative. Taking oral antibiotics ahead of time isn't likely to help because the bacterium can return before labor begins.

Antibiotic treatment during labor is also recommended for women who:

  • Have a urinary tract infection caused by group B strep
  • Delivered a previous baby with group B strep disease
  • Develop a fever during labor
  • Haven't delivered the baby within 18 hours of the membranes rupturing
  • Go into labor before 37 weeks and haven't been tested for group B strep

Antibiotic therapy isn't usually needed for women who have C-sections.

How group B strep affects baby's first days

Group B strep typically doesn't affect the length of time you and your baby spend in the hospital — and it doesn't affect your ability to breast-feed safely.

Your baby will be carefully monitored after delivery. If your baby's doctor suspects a group B strep infection, a sample of your baby's blood or spinal fluid will be tested for group B strep. If the test is positive, your baby will be given IV antibiotics. In some cases, IV fluids, oxygen or other medications may be needed as well.

Ease your anxiety

The possibility of group B strep disease is scary — but remember that the condition is rare. A woman who has group B strep but doesn't receive antibiotics during labor has a one in 200 chance of delivering a baby with group B strep disease, according to the CDC. But with antibiotic treatment during labor, a full-term baby born to a mother who carries group B strep has only a one in 4,000 chance of developing group B strep disease.

If you test positive for group B strep, remind your health care team during labor. Don't worry about repeating yourself or seeming overly anxious. Your reminders will help your health care team provide the best possible care during labor and delivery.


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