Group B Strep in Pregnancy

By: Bradley G. Goldberg, M.D.

Many couples who have recently had a child may have heard something about the Group B Strep (streptococcus) bacteria.

Bacteria are all around us. In fact, bacteria are all over us! On our skin, in our mouths, as well as other (more private) places. No matter how clean we try to be, these bacteria are a part of our lives. At any given time any one of us has 20, 30 or even more different types of bacteria on our bodies and the Group B Strep bacteria is just one of those that may be present.

Before doctors started screening and treating for this bacteria, Group B Strep was one of the most common causes of serious infections in the newborn. This included pneumonia, meningitis, and generalized sepsis (infection in the bloodstream), among others. While these types of infections have not been completely eliminated, they have been significantly decreased since screening started in the early 90’s.

Currently, The American College of Obstetricians and Gynecologists (ACOG) endorses two types of screening for the Group B Strep bacteria. The first option is the method I utilize in my practice and involves screening all pregnant women with a culture (using a Q-tip) between the 35-37th weeks of pregnancy.

Just over 30% of these women will test positive. While the bacteria poses no significant risk to the woman, as I mentioned previously it has potential to cause serious infection in the newborn. Therefore, all women who test positive for this bacterium will be treated with intravenous antibiotics during labor to protect the baby. This treatment significantly decreases, though does not completely eliminate, the risks to the baby.

Parents should be aware that even though the mother receives these antibiotics, the baby will most likely need to be observed in the hospital for a full 48 hours as a precautionary measure.

The second option currently endorsed by ACOG is to bypass the culture and instead to treat women with antibiotics who meet certain “high risk” criteria. While this approach is considered acceptable, recent studies show that it may not be as effective in preventing the newborn infections as the culture based method.

In summary, Group B Strep is one of many different types of bacteria that may be found on the human body. While women who test positive during pregnancy are not at significant risk for infection themselves, their babies may be. Therefore these women are treated with antibiotics during labor to protect the baby. This treatment has been successful in significantly decreasing some of the more common infections in the newborn.
 

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