Understanding your Group B Strep status is something every mum-to-be should know, says DR CHRISTOPHER NG.

What is Group B Strep?

Group B streptococcus (GBS) is one of many bacteria that can be present in our bodies which usually causes no harm. This occurs when we are being colonised with GBS. GBS is commonly found in both the digestive system and the female genital tract system.

How can it affect your baby?

It is important to point out that most pregnant women who developed GBS bacterial infections during their pregnancy give birth to health babies. In other words, although many babies come into contact with GBS around the time of labour and birth, most are unaffected. There is a small group of women in which the GBS can pass to the baby during childbirth causing serious life-threatening complications. Very rarely would GBS infections contracted during pregnancy cause preterm labour, miscarriage or stillbirths.

Early-onset GBS infections occur less than seven days after birth and most babies within 12 hours of birth will develop symptoms. Early-onset GBS infection can cause long term effects such as cerebral palsy, deafness, blindness and serious learning difficulties.

The life threatening complications include infection of the lining of the brain (meningitis), infection of the lung (pneumonia) and blood infection (septicaemia). One in five babies who survive the GBS infection will have the permanent affects as mentioned above.

Late-onset GBS infection develops seven or more days after birth. This infection is not related to the pregnancy and the baby most likely got infected from an infectious source while in hospital.

Very rarely would GBS infections affect the pregnant mother resulting in urine and womb infections or even a generalised septicaemia.

What are the test and treatment?

There is a higher risk of your baby being affected by this infection if:

• you develop preterm labour (before 37 completed weeks of gestation)
• your membranes have been ruptured for more than 18 hours
• you develop a fever during labour which is higher than 38°C

Other risk factors include:

• a past history of  your baby having had GBS infection
• developing a GBS urine infection during your current pregnancy
• a positive GBS swab from your vagina or rectum during your current pregnancy because of abnormal vaginal discharge

Management of GBS revolves around identifying pregnant women who are at higher risk of passing GBS infection to their baby during labour by looking out for the above risk factors.

For example during pregnancy, oral antibiotic treatment is given if:

• GBS has been found on your urine, vaginal or rectal swabs
• a past history of  your baby having had GBS infection

During labour, intravenous antibiotics is given if:

• GBS is found in your urine, vaginal or rectal swabs during your pregnancy
• you have previously had a baby who had a GBS infection
• you develop preterm labour (before 37 completed weeks of gestation)
• your membranes have been ruptured for more than 18 hours
• you develop a fever during labour which is higher than 38°C

The recommended practice of administering intravenous antibiotics during pregnancy for the above risk factors reduces the risk of infections to newborn babies by approximately 90 per cent. It is important to highlight that with vigilance and prompt treatment by your gynaecologist, GBS infections of the newborn can be prevented. Being this in mind, most babies who become infected with GBS can be treated successfully and will make a full recovery.