Group B Streptococcus Infection in Newborns
What is group B streptococcus?Group B streptococcus (strep) is a type of bacteria. It can be found in the digestive tract, urinary tract, and genital area of adults. About 1 in 4 pregnant women carry GBS in their rectum or vagina. During pregnancy, the mother can pass the infection to the baby. The fetus can get GBS during pregnancy. Newborns can get it from the mother's genital tract during delivery. GBS infection usually does not cause problems in healthy women before pregnancy. But it can cause serious illness for a newborn baby.
What causes group B infection?Many adults carry group B streptococcus (strep) bacteria in their digestive tract, urinary tract, and genital area. About 1 in 4 pregnant women carry it in their rectum or vagina. During pregnancy, the mother can pass the infection to the baby. Newborns can get it from the mother's genital tract during delivery.
Who is at risk for group B strep?Newborns are more likely to get group B strep infection if the mother has:
- Preterm labor
- Early breaking of water (rupture of membranes)
- A long time between rupture of membranes and birth
- Internal fetal monitoring during labor
- A past pregnancy with an infant who developed group B strep
- African-American or Hispanic ethnicity
What are the symptoms of group B strep infection?
Newborn babies with group B strep usually get symptoms in the first 24 hours after birth. These symptoms may include:
- Baby is fussy, very sleepy, and has breathing problems (signs of sepsis)
- Baby breathes fast and makes grunting noises (signs of pneumonia)
- Baby has breathing problems and periods of not breathing (signs of meningitis)
- Baby has a change in blood pressure or seizure
Babies who get group B strep a week or so after birth may have these symptoms:
- Decreased movement of an arm or leg
- Pain with movement of an arm or leg
- Breathing problems
- Red area on the face or other part of the body
Pregnant women may have group B strep without symptoms. When they have symptoms, symptoms may include:
- Having to urinate often, having an urge to go, or pain when urinating
- Nausea and vomiting
- Pain in your side or back
- Uterus or belly is sore or tender
- Rapid heart rate
How is group B strep diagnosed?
Your baby's healthcare provider will test the baby’s sterile body fluids, such as blood or spinal fluid. Most newborns with group B strep infection have symptoms in the first few hours after birth.
All pregnant women should be tested for group B strep as a part of routine prenatal care. In late pregnancy, your healthcare provider can test for GBS by taking a swab of your vagina and rectum during a pelvic exam. He or she can also test your urine for GBS. The swab or urine is sent to a lab to grow the bacteria. Tests are usually done between 35 and 37 weeks of pregnancy. The results may take a few days. A woman who is a GBS carrier may test positive at certain times and not at others.
How is group B strep treated?
Treatment of group B strep depends on whether it is diagnosed during pregnancy or after delivery.
Newborns ill with group B strep infection may need care in the newborn intensive care unit (NICU). They are usually given IV antibiotics. The newborn may need other treatments and special care if the infection is bad or if the baby has other serious problems such as meningitis or pneumonia.
If you have a positive GBS test during pregnancy, you will get intravenous (IV) antibiotics during labor. This lowers the risk that the baby will get the infection. Penicillin is the most common antibiotic given. Tell your healthcare provider about any medicine allergies. You may also need treatment if you have certain risk factors. These include:
- Fever during labor
- Water breaks (rupture of membranes) for 18 hours or longer before delivery during a full-term pregnancy and your doctor doesn't know if you have GBS
- Labor or rupture of membranes before 37 weeks (preterm) and the doctor doesn't know if you have GBS
- GBS infection in a previous baby
What are the complications of group B strep?
Group B strep is the most common cause of serious infections in newborns. Premature babies are more likely to get GBS infection than full-term babies.
Although rare, GBS infection may also happen in babies a week to several months after birth. Meningitis is more common when this happens.
In some pregnant women, GBS infection may cause chorioamnionitis. This is infection of the amniotic fluid, sac, and placenta. It can also cause a postpartum infection (endometritis). Urinary tract infections caused by GBS can lead to preterm labor and birth. Pregnant women with GBS are more likely to need a cesarean delivery. They are also more likely to have heavy bleeding after delivery.
Can group B strep be prevented?
Healthcare providers screen all pregnant women for GBS in late pregnancy. This can tell which women need treatment so that their infant does not get the infection. High-risk pregnant women may be given antibiotics before labor and birth to prevent GBS. It is important to understand that some babies still get GBS even with testing and treatment. Research is ongoing to make vaccines to prevent GBS disease.
When should I call my child's healthcare provider?
Most newborns with GBS have symptoms before they go home from the hospital. But some babies do not show symptoms until later. Symptoms include:
- Decreased movement of a leg or arm
- Pain with movement of a leg or arm
- Breathing problems
- Red area on the face or other body area
If your baby has any of these symptoms, call your child's healthcare provider right away.
Key points about group B strep
- Group B strep is a type of bacteria that can be passed from a pregnant mother to her newborn.
- A newborn infected with GBS can develop serious illnesses.
- Pregnant women are screened for GBS in late pregnancy. Treatment can be given before labor and birth.
- A history of GBS in a past pregnancy increases a woman's risk of having it in future pregnancies. It is important to tell your healthcare provider if you have ever had a GBS infection.
- Early treatment is important if a baby gets a GBS infection.
Tips to help you get the most from a visit to your child’s healthcare provider:
- Know the reason for the visit and what you want to happen.
- Before your visit, write down questions you want answered.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
- Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
- Ask if your child’s condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if your child does not take the medicine or have the test or procedure.
- If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.