Overview

Group B streptococcus (strep) is a type of bacteria. It can be found in the digestive tract, urinary tract, and genital area of adults. GBS infection usually does not cause problems in healthy women before pregnancy. But it can cause serious illness for a newborn baby. It may cause sepsis, pneumonia, meningitis, or seizures.

Causes

About 1 in 4 pregnant women have GBS in their rectum or vagina. During pregnancy, the mother can pass GBS to the baby. A baby can get it from the mother's genital tract during birth.

Risk Factors

Newborns are more likely to get group B strep infection if the mother has:

  • Preterm labor
  • Early breaking of water (rupture of membranes)
  • A long time between rupture of membranes and birth
  • Internal fetal monitoring during labor
  • Fever
  • A past pregnancy with a baby who had group B strep
  • African-American or Hispanic ethnicity
  • Group B strep in urine (bacteruria) with this pregnancy

Symptoms

Newborn babies with group B strep usually have signs in the first 24 hours after birth. These signs may include:

  • Being fussy, very sleepy, and having breathing problems (signs of sepsis)
  • Breathing fast and making grunting noises (signs of pneumonia)
  • Having breathing problems and periods of not breathing (signs of meningitis)
  • Having a change in blood pressure
  • Having convulsions (seizure)

Babies who get group B strep a week or so after birth may have signs such as:

  • Decreased movement of an arm or leg
  • Pain with movement of an arm or leg
  • Breathing problems
  • Fever
  • Red area on the face or other part of the body

Pregnant women may have group B strep without symptoms. When they have symptoms, these may include:

  • Having to urinate often, having an urge to go, or pain when urinating
  • Fever
  • Nausea and vomiting
  • Pain in your side or back
  • Uterus or belly is sore 
  • Fast heart rate

Diagnosis

Most newborns with group B strep infection have signs in the first few hours after birth. Your baby's healthcare provider will test your baby’s body fluids, such as blood or spinal fluid.

Treatment

Newborn babies who are ill with group B strep infection may need care in the newborn intensive care unit (NICU). They are usually given IV antibiotics. Your baby may need other treatments if the infection is severe or if he or she has meningitis or pneumonia.

Complications

In some pregnant women, GBS infection may cause chorioamnionitis. This is infection of the amniotic fluid, sac, and placenta. It can also cause a postpartum infection (endometritis). Urinary tract infections caused by GBS can lead to preterm labor and birth. Pregnant women with GBS are more likely to need a cesarean delivery. They are also more likely to have heavy bleeding after delivery.

Group B strep is the most common cause of serious infections in newborns. GBS infection can lead to meningitis, pneumonia, or sepsis. Meningitis is more common in a baby who has a GBS infection happen a week to several months after birth. 

Prevention

All pregnant women should be tested for group B strep as a part of routine prenatal care. In late pregnancy, your healthcare provider can test for GBS by taking a swab of your vagina and rectum during a pelvic exam. He or she can also test your urine for GBS. The swab or urine is sent to a lab to grow the bacteria. Tests are usually done between 35 and 37 weeks of pregnancy. The results may take a few days. A woman who has GBS may test positive at certain times and not at others. 

If you test positive for GBS during pregnancy, you will get intravenous (IV) antibiotics during labor. This lowers the risk that your baby will get the infection. Penicillin is the most common antibiotic given. Tell your healthcare provider if you have any medicine allergies. 

If you have not been diagnosed with GBS, you may be given antibiotics before labor and birth if you have certain risk factors. These include:

  • GBS infection in a previous baby
  • Labor or waters breaking (rupture of membranes) before 37 weeks (preterm) 
  • Rupture of membranes18 hours or longer before delivery of a full-term pregnancy 
  • Fever during labor

Some babies still get GBS even with testing and treatment. Research is ongoing to make vaccines to prevent GBS infection.

When to Call a Healthcare Provider

Most newborns with GBS have signs before they go home from the hospital. But some babies do not show signs until later. These may include:

  • Decreased movement of a leg or arm
  • Pain with movement of a leg or arm
  • Breathing problems
  • Fever
  • Red area on the face or other body area

 If your baby has any of these symptoms, call your child's healthcare provider right away.

Key Points

  • Group B strep is a type of bacteria. It can be passed from a pregnant mother to her newborn baby.
  • A baby infected with GBS can develop serious illnesses.
  • Pregnant women are screened for GBS in late pregnancy. Treatment can be given before labor and birth.
  • A history of GBS in a past pregnancy increases a woman's risk of having it again. Tell your healthcare provider if you have ever had a GBS infection.
  • Early treatment is important for a baby with a GBS infection.

Next Steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.