July is Group B Strep Awareness Month, so I’m resharing this post about the subject. Towards the end of my second pregnancy, by fluke I discovered I was carrying group B streptococcus (also known as group B strep or GBS). It was only by chance that I ever received a strep b test – I attended A&E about something unrelated which required a swab.
I didn’t even realise I’d been checked for GBS too until I received a phone call to let me know the test had come back positive. Of course my immediate thought was how dangerous is Group B Strep during pregnancy?
The first thing I was told by the midwife who called me was that I should not research the condition online. That’s why I’m writing about it today – there are lots of horror stories available care of Mr Google, and I want to dilute those with a factual post.
It can be very serious, but that’s not the whole story, and it’s important to be educated to avoid unnecessary scaremongering. Plus, of course, if you’ve recently been diagnosed yourself, you’ll be looking for information and reassurance.
What is Group B Strep?
Group B streptococcus, or GBS, is a bacteria affecting around 20% of women. Usually it’s harmless with no symptoms and many women give birth with no issues at all, without ever knowing they were carrying it.
In rare cases, when a baby is born to an affected woman and colonised, this can lead to infection which is serious and must be treated swiftly and appropriately with antibiotics.
Early Onset GBS
Early onset GBS is when a baby develops the infection within seven days of birth, and usually within twelve hours. Symptoms include:
- Not feeding well;
- High or low temperature;
- Fast or slow heart rate;
- Being floppy and unresponsive;
- Fast or slow breathing rates.
Late-onset GBS infection
This is when infection occurs seven or more days after a baby is born. It’s not usually associated with pregnancy, and the likelihood is that the baby became infected after birth from somebody else.
GBS infections after three months of age are extremely rare.
Breastfeeding does not increase the risk of group B strep and will protect your baby against other infections.
Complications of GBS Infection
In most cases, babies who become infected with group B strep can be successfully treated and go on to make a full recovery.
However, in rare cases the infection can sometimes cause life-threatening complications, including:
Click here for more information about the rare complications associated with group B streptococcus infection.
Increased Risk of Early Onset GBS
Infection is more likely if:
- Your baby is born before 37 weeks of pregnancy – the earlier your baby is born, the greater the risk;
- You previously had a baby with a GBS infection;
- Your baby is born more than 18 hours after your waters broke;
- You have a high temperature during labour.
To reduce the risk of infection, mothers of high-risk babies are offered antibiotics during labour.
Treatment of GBS in Pregnancy
If you’re diagnosed in the late stages of pregnancy, as I was, you’ll be offered antibiotics during labour. Two doses should be given intravenously, four hours apart, and so it’s important to get to the labour ward in good time. Of course, babies are notorious for liking to surprise us… Which is exactly what my little Elfin did.
It didn’t help matters that the midwife I spoke to at the hospital didn’t want us to arrive before I was contracting three times in ten minutes. Except I went from zero to nearly-giving-birth-on-the-bathroom-floor in the space of about forty minutes!
How Dangerous is Group B Strep During Pregnancy?
Thankfully, even in that scenario it’s rare for your baby to become poorly.
I received one round of antibiotics before Elfin decided she was ready to make an appearance, which you can read all about here if you’re interested! Because I’d not had time to receive the recommended two courses, we were kept in for observations for twelve hours to ensure Elfin was well.
Although the diagnosis was frightening, the reality is that complications are very uncommon.
Should Women Be Routinely Offered a Strep B Test During Pregnancy?
You may be aware of campaigns to make testing for GBS routine during pregnancy. As with any risk to your new baby, I understand the fear driving the desire to create this change. However it’s not something I think we should be doing, and here’s why:
Whilst GBS can be serious, diagnosis is somewhat futile.
The bacteria can lie dormant, meaning you could test positive one week, but negative the next – and vice versa. So you could test negative in the late stages of your pregnancy and believe you’re safe, yet still go on to have a problem. Likewise, you could test positive but no longer have any threat of colonisation when you go into labour.
I was fortunate to be swabbed so close to my due date, but that’s unusual. What it shows however, is that in the most opportune window, you will be tested as a matter of course should you happen to be swabbed for any other reason.
With a condition that’s so rare and unreliable, I’d personally prefer to save the cost to the NHS of routinely swabbing every pregnant woman. Given that false negatives are possible, it feels like a futile and potentially dangerous exercise.
Educating Families About GBS is a Better Approach
I’m more comfortable knowing that early symptoms are carefully watched for, and serve as a red flag to the midwives caring for us and our babies. Of course I understand why some women feel routine testing is akin to an insurance policy, but my concern is that in receiving a negative result, we run the risk of complacency.
I’d far prefer that families are educated about the condition and know what symptoms to be looking for. On balance, it feels like a safer approach than a test which is known to produce false results.
What do you think? Should we be routinely tested for GBS during pregnancy?