Group B Strep GBS

​GBS is one of many bacteria that can be present in our bodies. It doesn’t usually cause any harm. When this happens is called ‘carrying’ GBS or being colonised with GBS. It’s estimated about one pregnant women in four in the UK carries GBS in their digestive system or vagina. Around the time of labour and birth, many babies come into contact with GBS and are colonised by the bacteria. Most are unaffected but a small number can become infected. Most pregnant women who carry GBS bacteria have healthy babies. However, there's a small risk that GBS can pass to the baby during birth. Sometimes GBS infection in newborn babies can cause serious complications that can be life threatening, but this is not common. Extremely rarely, GBS infection during pregnancy can also cause miscarriage, early (preterm) labour or stillbirth.

 

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Early-onset GBS

If a baby develops GBS infection less than seven days after birth, its known as early-onset GBS infection Most babies who become infected develop symptoms within 12 hours of birth.

The signs and symptoms of early-onset GBS are;

  • Being floppy or unresponsive

  • Not feeding well

  • Grunting

  • High or low temperature

  • Fast or slow heart rates

  • Fast or slow breathing rates

  • Irritability

  • Low blood sugar

  • Low blood pressure

Preventing early-onset GBS infection.
The Royal College of Obstertician and Gynaecolognists (RCOG) has published guidance for healthcare professionals on preventing early-onset GBS infection. If yo have previously had a baby with GBS, your maternity team will either monitor the health of your newborn baby closely for at least 12 hours after birth or treat them with antibiotics until blood tests confirm whether or not GBS is present.

 

Late-onset GBS

Late-onset GBS infection develops seven or more days after a baby is born. This isn’t usually associated with pregnancy. The baby probably became infected after birth, for example, they may have caught the infection from someone else.

The signs and symptoms of late-onset GBS are;

  • High or low temperature

  • Being unresponsive

  • Not feeding

  • Grunting

  • High or low blood pressure

  • Turns way from bright lights

  • Pale, blotchy skin

  • Blank, staring or trance expression

  • Being irritable with a high pitch whimpering cry or moaning.

 

GBS infections after three months of age are extremely rare. Breastfeeding doesn’t increase the risk of GBS infection and will protect your baby against other infections.

 

What complications can GBS infection cause?

Most babies who become infected can be treated successfully and will make a full recovery. However, even with the best medical care the infection can sometimes cause life-threatening complications, such as;

  • Blood poisoning (septicaemia)

  • Infection of the lung (pneumonia)

  • Infection of the lining of the brain (meningitis)

 

One in 10 babies born with GBS will die from the infection. Another one in 5 babies who survive the infection will be affected permanently. Early-Onset GBS infection can cause problems such as cerebral palsy, deafness, blindness and serious learning difficulties.

Rarely GBS can cause infection in the mother, for example, in the womb or urinary tracts, or more seriously an infection that spreads through the blood, causing symptoms to develop throughout the whole body (sepsis).

 

Why the test?

With infections as serious as those caused by GBS, prevention is much better than treatment.

 

Currently the best way of knowing which women carry GBS in labour in through testing for GBS at 35-37 weeks of pregnancy – using sensitive enriched culture method (ECM) tests. If a lady tests positive, then preventive measures can minimise the risk of transmission to the baby. Intravenous antibiotics given in labour to women whose babies are at higher risk of developing GBS infection have been proven to dramatically reduce that risk.

 

Screening for GBS is not recommended by the UK national Screening Committee nor Royal College of Obstetricians and Gynaecologists. The current policy is centred around using a ‘risk factor’ approach to determine which women are at risk. Risk factors include carrying GBS this pregnancy, high temperature during labour, labour starting or waters breaking prematurely and having previously had a baby infected with a GBS infection. Unfortunately, since the introduction of this strategy in 2003, the rate of early-onset GBS infection is babies has not fallen. Furthermore, up to 40% of babies who do become affected are born to mothers without any of these clinical risk factors, other than unknown GBS carriage within the mother.

 

An antenatal screening program, using tests specially designed to detect GBS carriage, would identify more women who's babies are at increased risk of GBS infection than using the risk factors alone. Giving all higher-risk women targeted, low-spectrum antibiotics in labour could result in significant drop in the cases of early onset GBS infections. Countries which have done this have seen their incidence fall by 71-86%. Research shows that s a result of these addition cases being prevented, this could save the government an estimated £37 million per year.

 

Laboratory testing is the only way in which GBS carriage can be reliably identified.

 

Knowing the result of a test sensitive for GBS is always good news. If its negative within 5 weeks of delivery, then its hugely unlikely the baby will develop GBS infection. If it’s positive, although it does mean that the baby is at a raised risk of developing GBS infection, it also means that – as the GBS carriage has been identified – simple, straightforward steps can be taken which have been proven to be extremely effective at minimising that risk.


We at The Blayzeing Star charity offer to help fund the GBS test for you if you would like to have it done. If you'd like us to help fund it for you please use our contact form and we will arrange the test for you, or you can buy a test on our website.