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Pregnancy and Childbirth: The answers
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Early and Late Group B Streptococcal Infection

Early disease takes the form of blood poisoning (septicaemia) and there may be associated pneumonia and meningitis. In the vast majority, onset is within hours of birth but can be up to 7 days after.

 

The baby will present with irritability, lethargy, breathing difficulties and will soon turn blue (cyanosed). The progression of the disease is quite rapid and aggressive treatment is required as the disease is life-threatening and there are fatalities.

 

 

 

 

 

 

Late disease is usually in the form of  meningitis and could occur as late as three months after delivery. Roughly 20% of all GBS infections present late. Roughly half of these will occur to babies whose mothers are non-carriers of the bacteria.

 

GBS infection could also affect joints (septic arthritis), bones (osteomyelitis), the ear-canal (otitis media), the eye (conjunctivitis) and other parts of the body. These presentations are not common.

 

Group B Streptococcal Infection Prevention

In the United States and Canada, the recommendation is to do universal screening and offer antibiotic prophylaxis during labor to those women found to have a positive culture for GBS. A vaginal and rectal swab is taken for culture at 35-37 weeks of gestation.

 

In the UK, there is no universal screening for this ‘infection’. The logic being that the screening is unlikely to be reliable since colonization of the vagina by GBS bacteria is known to be intermittent. It therefore follows that a woman could test negative at some point during pregnancy but actually have the bacteria a few days or weeks down the line. The results therefore carry the risk of being misleading.

 

 

For those who are already known to carry the bacteria, there appears to be little or no value in giving them antibiotics during pregnancy and before labor. This is because, even though antibiotics are very effective in eliminating the bacteria, effectiveness appears to be temporary and the bacteria is likely to be back just a few weeks afterwards.

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A newborn is vulnerable to GBS infection

Group B streptococcal infection usually presents within hours of birth. However, it can present as late as three months after birth.