Some thoughts and data on Group B Strep

First, here’s a good overview of why physicians are concerned about group B strep http://www.meningitis.ca/groupbstrepdisease.html

Please note that this is a Canadian site, and their recommendations for prevention of transmission (the two approaches listed at the bottom of the webpage) are not the recommendations being followed right now in the US. See the protocols link below for info on that.

From the CDC: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/groupbstrep_g.htm

"Most GBS disease in newborns can be prevented by giving certain pregnant women antibiotics through the vein during labor. Any pregnant woman who previously had a baby with GBS disease or who has a urinary tract infection caused by GBS should receive antibiotics during labor. Pregnant women who carry GBS should be offered antibiotics at the time of labor or membrane rupture. GBS carriers at highest risk are those with any of the following conditions:

fever during labor

rupture of membranes (water breaking) 18 hours or more before delivery

labor or rupture of membranes before 37 weeks

Relative Risks

Because women who carry GBS but do not develop any of these three complications have a relatively low risk of delivering an infant with GBS disease, the decision to take antibiotics during labor should balance risks and benefits. Penicillin is very effective at preventing GBS disease in the newborn and is generally safe. A GBS carrier with none of the conditions listed above has the following risks:

1 in 200 chance of delivering a baby with GBS disease if antibiotics are not given

1 in 4000 chance of delivering a baby with GBS disease if antibiotics are given

1 in 10 chance, or lower, of experiencing a mild allergic reaction to penicillin (such as rash)

1 in 10, 000 chance of developing a severe allergic reaction--anaphylaxis--to penicillin. Anaphylaxis requires emergency treatment and can be life-threatening.

If a prenatal culture for GBS was not done or the results are not available, physicians may give antibiotics to women with one or more of the risk conditions listed above.”

For more info on group b strep:

Testing and/or treatment used to be done in only some women, based on a risk assessment model. ACOG, AAP, and the CDC are all now recommending routine testing. Here's info on the protocol: http://www.phyins.com/pi/risk/pdf/GrpB.pdf

For a bit of trivia... here's info on the campaign to make group B strep testing routine which was led by parents of a child severely affected by group B strep: http://www.groupbstrep.com/victory.htm

Here's some midwife archives of other info on group b strep http://www.gentlebirth.org/archives/gbs.html#Membrane