February is International Prenatal Infection Prevention Month and a discussion about the prevention of Group B Streptococcal infection (GBS) is necessary because it is the leading infectious cause of illness among newborns in the United States. Untreated GBS can cause serious infections including meningitis and bacteria in the blood stream of newborns.
The good news is that the number of cases of GBS has declined in the U.S. during the past 15 years. The bad news is that 4 % of newborns die each year because of the infection. Infections of the newborn are classified as early onset or late onset disease. Early onset GBS usually occurs within 48 hours after birth or within the first week of life. Late onset GBS usually occurs after the first week of life. 20% of pregnant women have GBS on their vaginal wall but do not exhibit any symptoms and are called carriers. It is for this reason why pregnant women need testing for GBS infections between 35 and 37 weeks gestation.
If a pregnant woman’s GBS culture is positive, treatment of the infection is usually postponed until the patient is actually in labor to protect the infant as it is being born. Who is at risk for developing GBS?
- Premature babies or low-weight babies who weigh less than 5 pounds at birth
- Pregnant women who develop a fever while in labor
- Women who have ruptured (or broke) their membranes for greater than 18 hours
- Women who had a previous infant infected with GBS
- Pregnant women with a GBS urinary tract infection
A woman with a positive GBS culture should receive intravenous penicillin every four hours while in labor and erythromycin is no longer accepted as a substitute of the patient has a penicillin allergy. Cefazolin antibiotics are recommended for women who do not have a severe penicillin allergy and Ampicillin may be used as well. If a woman ruptures her membranes before thirty-six weeks and has a negative GBS culture, intravenous penicillin is not necessary per the guidelines of the American College of Obstetricians and the Center of Disease Control (CDC).
Because GBS is a preventable infection of newborns if detected and treated at birth, it is imperative that every pregnant woman be tested for the infection in order to protect their baby. Remember, a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.