STREPTOCOCCUS B TESTING IN PREGNANCY
Streptococcus B Testing in Pregnancy (GBS Testing).
Streptococcus B infection is the most common cause of infection in newborns in the first three months of life. Early onset occurs within the first week of birth and has the potential to cause serious infection such as sepsis, pneumonia or meningitis. A later onset of the disease occurs between 7-89 days of age and can cause similar illness to the early onset GBS, but it tends to be more commonly meningitis. The World Health Organisation estimates that 10-30% of women carry GBS in their vagina or rectum and say that GBS is responsible for more than 500,000 premature births and an estimated 150,000 stillbirths per year globally.
It is important first to say that GBS is not a sexually transmitted disease, and for the most part the chances are you are unaware of carrying the bacteria as there are in most cases no symptoms and it is not harmful to you. But it can be transmitted to your baby during a vaginal delivery potentially causing your baby to be sick in the first few days, or weeks of life.
By identifying which women are GBS positive in later pregnancy enables the mother to be treated in labour and therefore reduces the risk of the bacteria spreading to her baby.
The World Health Organisation has recommended universal screening of GBS between the 35th -37th week of pregnancy since 2024.
Screening policies in European countries vary. Many countries now are adopting universal screening. At the time of writing this, Germany, Italy, France and Spain are offering screening. Some countries such as the UK do not offer routine testing but instead use a risk based assessment. For other European countries, it can be dependent on the health care provider you are booked with, or the insurance policy you have . That said, there is almost always the possibility to have this test done privately.
Screening is easy and painless, involving a swab being taken by the midwife or doctor at a routine antenatal visit around 36 weeks gestation. If the swab comes back negative then no further action needs to be taken.
If your swab comes back positive to GBS, nothing needs to be done until you go into labour. What is important if you are GBS positive is once you have signs of labour whether that is contractions, or if you have premature rupture of your membranes, (waters going), then you should phone up your intended place of delivery immediately to inform them you are in labour and that you are GBS positive. They will then advice you accordingly.
Treatment in labour usually involves the mother having intra venous antibiotics . Penicillin is usually the drug of choice unless the mother is sensitive /allergic to penicillin then another antibiotic will be used.
Post delivery the baby is observed for signs of infection for at least the first 12 hours, and in some hospitals the baby will also have swabs taken to see if the cultures are positive for GBS.
What Does a Positive GBS result mean for my baby?
If baby is found to be GBS positive in the neonatal period then baby will need intra venous penicillin and observation in hospital until assessed fit for discharge.
Typical Signs of GBS infection in a newborn
If your baby is at higher risk of GBS then you and your baby will be in hospital until the medical staff are happy that all the results have come back negative.
Most signs of GBS in a newborn occur within the first 12hours of life, so for the most part you are still in the hospital. But signs to look out for that your baby needs medical attention are:
-Noisy breathing, with grunting or groaning, baby seems to be working hard to breath
-Baby being very sleep or in extreme cases unresponsive
-Floppy baby
-Not feeding well
-Baby's temperature is either high, or the temperature is low, almost hypothermic
Onset of GBS later in the neonatal period is rarer, but not impossible.
Further Reading/ References.
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