Last updated on August 16th, 2018 at 09:49 am

Only around 50% of new and expectant mums know anything about group B strep (GBS) so every year, in July,  Group B Strep Support (GBSS) organises events and campaigns to raise awareness of it and to think about the babies that have been affected by it.

What is group B strep?

Group B streptococcus is a bacterium that can be found in the digestive and lower vaginal tract of around 20-30% of adults in the UK.  It is usually harmless in adults, although it can cause infections in those with chronic conditions such as diabetes, cardiovascular disease or liver disease, or the elderly.  However, pregnant women who carry GBS can pass this on to their baby as it passes through the birth canal during delivery and it can have devastating, and sometimes fatal, consequences for newborns.

There are 2 main types of GBS:

• Early-onset disease, which occurs during the first week of life, although most babies will develop symptoms within 12 hours of birth if they are affected.
• Late-onset disease, which can occur from the first week of birth up until 3 months of age.

How does group strep B affect babies?

GBS can cause life-threatening infections in new born babies such as:

• septicaemia (infection of the blood)
• pneumonia (infection in the lungs)
• meningitis (infection in the protective membranes that surround the brain and spinal cord) – more likely to affect babies with late on-set of the disease.

Babies that survive the disease can be left with long term physical disabilities.

Are all babies affected?

Not all babies born to mothers who carry GBS will be infected, in fact only a small percentage are.  Being a carrier doesn’t mean that the infection will be passed on during labour and delivery.  Where a woman is diagnosed as being at risk of passing the infection to her baby, she will be given intravenous antibiotics as soon as labour has started, although to maximise efficiency the first dose should be given at last 2 hours before delivery.

Are there any symptoms of GBS in babies?

Early on-set GBS may present some of the following symptoms in babies:

• abnormal/irregular heartbeat
• difficulties in breathing, such as
  • grunting
  • rapid breathing
  • short periods of not breathing
  • nostril flaring
• appearing anxious or stressed
• blue appearance (cyanosis)
• pale appearance with cold skin
• drowsiness
• low blood sugar
• poor feeding
• high or low temperature
• low blood pressure

Similar signs may indicate late-onset GBS, but there may also be signs that are indicative of meningitis such as:

• high fever with cold hands and feet
• not feeding
• vomiting
• not wanting to be picked up and seeming agitated
• very sleepy and appearing floppy and unresponsive
• grunting or breathing rapidly
• an unusual cry that appears high-pitched or moaning
• pale, blotchy skin, with a red rash that doesn’t fade when a glass is rolled over it
• tense, bulging soft spot on the head (fontanelle)
• a stiff neck and showing a dislike to bright lights
• convulsions or seizures

When is the risk of GBS increased?

The risk of a baby being infected can increase if the expectant mother:

• goes into labour before 37 weeks of pregnancy
• finds her waters break 18 hours or more before the baby is born
• has a temperature higher than 37.8°C during labour
• carries GBS in her vagina during the pregnancy
• has had GBS found in her urine at any time during the pregnancy
• has previously had a baby infected with GBS

Can the risk be managed?

Prevention is certainly better than cure (or treatment) in the case of GBS, with intravenous antibiotics given at the right time deemed the most effective solution.

In the UK, mothers are not routinely screened for GBS and it is not currently recommended by the UK National Screening Committee nor the Royal College of Obstetricians & Gynaecologists (RCOG).

Healthcare professionals manage the risk factors above in high risk pregnancies, but figures show that the rate of early on-set of GBS in babies hasn’t fallen since the strategy was introduced in 2003 and that 40% of babies who are affected by GBS are born of mothers who showed none of the above risk factors.

A recent RCOG audit recommended that:

• National guidelines should be revised to reflect the findings from this audit, the forthcoming guidance from the UK National Screening Committee and the forthcoming results from the recent national GBS surveillance study. To reduce future deviations in local practice and policy, the national guidelines should be applied to all NHS trusts.
• Local protocols must be reviewed every three years to ensure they are fit for purpose and that they reflect current national guidance.
• Future studies on preventive care for EOGBS should address care provided in midwife-led units as well as obstetric-led units.
• Admission criteria and practice in midwife-led units should be informed by national guidelines.
• A nationally produced patient information leaflet should be used locally by all NHS trusts.

Find out more about the audit.

So is screening the way forward?

The National Screening Committee has the view that screening should not be routinely offered to all pregnant women, as it believes that the benefits do not outweigh the risks of the antibiotics.  However, a pilot study at Northwick Park Hospital found that over a 12 month period no babies contracted GBS where their mothers had been screened and treated with antibiotics and the only recorded cases of babies with GBS were those from mothers who had not agreed to be screened.

Furthermore, in May this year, Professor Philip Steer, chair of the Group B Strep Support Medical Advisory Panel and emeritus professor of obstetrics at Imperial College gave a speech to the Royal Society of Medicine suggesting that screening should be offered to all pregnant women.  A vote was taken after the speech in which 96% of those present voted in favour of his suggestion.

How can Graysons help?

Group B strep infection is curable, and the majority of babies treated will make a full recovery, but sadly, there are cases in which GBS was recognised before the birth but either no action or the wrong action was taken, as well as those where there was a failure by medical staff to recognise  the clinical signs and symptoms of sepsis during pregnancy and/or labour, or in a newborn..  In these cases, some children can suffer life threatening and catastrophic injuries.

We understand that the loss of a child, or caring for a child with a catastrophic injury can put severe pressure on a family, financially, psychologically and physically and we work with these families to help win compensation for the devastating effect it has on their lives.

For a confidential and free of charge discussion, please contact our experts now.

You can find out more about how we can help with birth injury and cerebral palsy claims on our web pages.