Protecting Your Baby from Group B Strep During Pregnancy and Childbirth

Group B Strep

You might not be aware, but if you’re pregnant, it’s important to be tested for a common bacteria called Group B Strep before delivering your baby. You could have Strep B and not even know it and pass it along to your baby.

What is Group B Strep?

Group B streptococcus [strep-tuh-KOK-uh s] (also called “group B strep” or simply “GBS”) is a common bacteria. Since these bacteria live in the human genital and gastrointestinal tract, it’s not the same bacteria that causes strep throat, and in adults it usually doesn’t cause illness. When a pregnant mom has Group B Strep it can be dangerous for her newborn because the unborn baby can be exposed to this bacterial environment once mom’s water breaks. For this reason, most healthcare providers and hospitals have adopted a national standard to screen all pregnant women for this bacteria. This ensures the best outcome for your baby. 

Why is Group B Strep in pregnancy a concern?

If you have Group B Strep during your pregnancy, there’s a chance you could pass the bacteria on to your baby. The bacteria can live in the rectum and vagina, so a baby can become infected during childbirth. Infection can cause serious, even life-threatening, problems in a newborn, such as lung infections, blood infections, and meningitis (inflammation of the tissues around the brain and spinal cord). That’s another important reason to keep all your prenatal visits and deliver in a hospital.

Group B Strep is common – ask your provider about testing

Studies show about 25 percent (1 out of 4) pregnant women carry the Group B Strep bacteria but have no symptoms. For this reason, it’s recommended that all pregnant women be tested for it late in pregnancy (usually starting at about 36 weeks gestation) to detect this common bacteria so that your doctor can plan steps to help protect your baby. Testing is sometimes done earlier if preterm delivery is anticipated. 

Testing is quick and simple. Your provider will swab your vagina and rectum and send the sample to a lab to be cultured. A positive test result means Group B Strep is present. A mom can test positive for GBS with one pregnancy and negative with a subsequent pregnancy. The culture result can take 1-2 days, so it is important to have this information before mom goes into labor. 

If you have Group B Strep, special precautions need to be taken before your baby is born

The most common cause of newborn infection is from GBS bacteria. Based on data from the Utah Department of Health from Jan 2015 - July 2019, the incidence of newborn infection caused by GBS is higher in Utah compared to the national incidence (UT 0.4 cases/1000 live births vs. national incidence of 0.22 cases/1000 live births). Symptoms can be very mild, but if left untreated, it can even cause death in the newborn. Screening all pregnant moms for GBS as well as treating those positive with GBS has significantly reduced the incidence of GBS infection in newborn infants. 

Your baby will need special treatment and care in any of these circumstances: 

  • You’ve tested positive for Group B Strep
  • You’ve previously had a baby who developed a Group B Strep infection after birth
  • You’ve had a urinary tract infection during pregnancy that was caused by Group B Strep
  • The labor is preterm (less than 37 weeks gestation) and you haven’t had a Group B Strep test
  • The labor is term and GBS is unknown and risk factors develop during labor 

Antibiotics administered during labor

To minimize the risk of passing Group B Strep to your baby, moms who test positive for Group B Strep will be given antibiotics during labor through an IV to help get rid of some of the bacteria. Sometimes extra monitoring and/or treatment may still be indicated for your baby if antibiotics are administered shortly before birth. If you’re planning a C-section delivery, your labor hasn’t begun, and your water hasn’t broken yet, you may not need antibiotics. 

After birth, your baby will need to be watched carefully for any signs of Group B Strep disease. Your baby’s physical exam, vital signs and blood pressure will be monitored more frequently and screening labs and/or blood cultures may be needed. Your baby may need antibiotics if there are any concerns for infection. 

Some signs of infection include:

  • Increased or rapid breathing
  • Needing oxygen
  • Abnormal vital signs such as high or low temperature or increased heart rate)
  • Fatigue
  • Disinterest in oral feeding
  • Decreased urine output. 

Depending on your baby’s clinical exam and lab results, care can be continued in a well-baby nursery or a Newborn Intensive Care Unit. 

Finding out moms are GBS positive in advance makes it more likely mom and baby can remain together after delivery. The overall goal is to treat babies who are at the highest risk of being infected with GBS bacteria, while limiting the exposure of all newborns to unnecessary antibiotics.