Group B streptococcus (also known as GBS, group B strep, or baby strep) is a common bacteria found in the vagina and rectum. GBS infection can be passed from mother to baby during childbirth and can cause serious illness and/or death in newborns. If the bacteria invade the womb during pregnancy, miscarriage, stillbirth and preterm delivery are possible. Knowing your GBS status and getting proper treatment can protect your newborn.
The Center for Disease Control (CDC) estimates that approximately 25% of women are colonized with GBS in the vagina or rectum. A pregnant mother may be unaware that she is a carrier of the bacteria. If the expecting mother is a carrier and does not have an infection, she will not have any symptoms of infection. Group B strep is not a sexually transmitted disease and is a naturally occurring bacteria in the body that comes and goes.
- Delivery at <37 weeks' gestation,
- Rupture of membranes (water breaks) for ≥18 hours, or
- Temperature of ≥100.4°F (38.0°C).
Any newborn with signs of sepsis should receive a full diagnostic evaluation and antibiotic therapy. “Full diagnostic evaluation” includes:
- a blood culture,
- a CBC (complete blood count),
- a chest x-ray (if infant is having respiratory issues),
- a lumbar puncture (spinal tap).
Well-appearing newborns whose mothers had suspected chorioamnionitis (infection of the amniotic sac) should undergo a limited evaluation and receive antibiotics. “Limited evaluation” includes
- a blood culture
- a CBC including
- Well-appearing infants whose mothers did not have chorioamnionitis and no indication for antibiotic therapy during labor should receive routine care.
- Well-appearing infants of any gestational age whose mother received adequate antibiotics during labor (≥4 hours of penicillin, ampicillin, or cefazolin before delivery) should be observed for at least 48 hours. No routine diagnostic testing is needed. Babies can be discharged home as early as 24 hours after delivery, assuming that other discharge criteria have been met, able to access medical care, and parent is able to comply with discharge instructions. If discharged home at 24 hours of life, it is recommended that your baby follows up with his/her primary care provider within 48 to 72 hours.
For well-appearing infants born to mothers who met criteria to receive antibiotics during labor but did not receive or did not receive adequate antibiotics (<4 hours before delivery or with an inappropriate antibiotic) during labor,:
- If the infant is well-appearing and ≥37 weeks and the duration of membrane rupture before delivery is less than 18 hours, then the infant should be observed for at least 48 hours. No routine diagnostic testing is recommended.
- If the infant is well-appearing and is either premature (<37 weeks) or membrane ruptures for 18 or more hours before delivery, then the infant should undergo a limited evaluation and observation for at least 48 hours.
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Author : Diba Tillery RN, BSN, IBCLC, CPST
1. American Academy of Pediatrics. Policy Statement Recommendations for the Prevention of Perinatal Group B Streptococcal (GBS) Disease. PEDIATRICS Vol. 128 No. 3 September 1, 2011. Published online August 1, 2011
CDC. MMWR Prevention of Perinatal Group B Streptococcal Disease Revised Guidelines from CDC, 2010. November 19, 2010 / Vol. 59 / No. RR-10
CDC: Group B Strep