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Group B Streptococcal Disease
- Before birth, bacteria in the vagina can spread up the birth canal into the uterus and infect the amniotic fluid surrounding the fetus. The baby becomes infected by inhaling the infected fluid.
- During delivery, by contact with bacteria in the birth canal
- After birth, by close physical contact with the mother
|Vaginal Bacteria Spreading to Fetus|
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- Mother currently has GBS in her vaginal or rectal area—This is confirmed by a lab test between weeks 35-37 of pregnancy.
- Mother is GBS positive and does not get antibiotics at least 4 hours before delivery
- Mother had a previous baby with GBS disease
- Mother has a urinary tract infection due to GBS
- Labor or rupture of the membranes before 37 weeks of pregnancy
- Rupture of the membranes for 18 hours or more before delivery
- Mother has a fever during labor
- Frequent vaginal examinations during labor
- Use of intrauterine fetal monitoring devices
- Abdominal pain
- Bad odor of amniotic fluid
- Unstable temperature—low or high
- Breathing problems
- Not eating well
- Difficulty waking
- Weakness or lacking energy—in late-onset disease
- Blood tests
- Culture tests
- Urine tests
- Spinal fluid test
- Screening pregnant women at 35-37 weeks—If GBS is found through the screening, IV antibiotics are given during labor and delivery.
For women who did not receive screening at 35-37 weeks,
an alternate strategy gives antibiotics during labor and delivery to women who:
- Are carriers of GBS bacteria
- Have previously had an infant with GBS disease
- Have GBS bacterium at any time during the present pregnancy
- Go into labor or have rupture of the membranes before the fetus has reached an estimated gestational age of 37 weeks
- Have rupture of membranes for 18 hours or more before delivery
- Have a fever during labor
- Have a urinary tract infection with GBS
The American Congress of Obstetricians and Gynecologists http://www.acog.org/For%5FPatients
Group B Strep Association http://www.groupbstrep.org
Society of Obstetricians and Gynaecologists of Canada http://www.sogc.org
Women's Health Matters http://www.womenshealthmatters.ca
De Tejada BM, Pfister RE, Renzi G, et al. Intrapartum Group B Streptococcus Detection by Rapid Polymerase Chain Reaction Assay for the Prevention of Neonatal Sepsis. Clin Microbiol Infect. 2010 Sep 22.
Group B strep (GBS). Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/groupbstrep/index.html. Updated May 23, 2011. Accessed June 19, 2014.
Group B strep infection: GBS. American Pregnancy Association website. Available at: http://www.americanpregnancy.org/pregnancycomplications/groupbstrepinfection.html. Updated March 2011. Accessed August 14, 2013. Group B streptococcal infection in infants less than 3 months old. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated May 19, 2014. Accessed June 19, 2014.
Ohlsson A, Shah VS. Intrapartum antibiotics for known maternal Group B streptococcal colonization. Cochrane Database Syst Rev. 2009 Jul 8;(3):CD007467.
Provisional Recommendations for the Prevention of Perinatal Group B Streptococcal Disease. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/groupbstrep/guidelines/downloads/provisional-recommendations-508.pdf. Updated July 2010. Accessed August 14, 2013.
Puopolo KM, Madoff LC, Eichenwald EC. Early-onset group B streptococcal disease in the era of maternal screening. Pediatrics. 2005 May;115(5):1240-6.
Woodgate P, Flenady V, Steer P. Intramuscular penicillin for the prevention of early onset group B streptococcal infection in newborn infants. Cochrane Database Syst Rev. 2004;(3):CD003667.
- Reviewer: Michael Woods, MD
- Review Date: 06/2014
- Update Date: 06/19/2014