Answers about Group B Strep in Pregnancy

Group B streptococcus, or GBS, is a type of bacterium that can cause sepsis (blood infection) and meningitis (infection of the fluid and lining surrounding the brain) in newborn babies. Although the number of newborns affected is fairly small, the number of women who carry the bacterium without knowing it is high.

Many people carry GBS in their bodies but do not become ill. These people are considered to be "carriers." Adults can carry GBS in the bowel, vagina, bladder, or throat. One of every four or five pregnant women carries GBS in the rectum or vagina. A fetus may come in contact with GBS before or during birth if the mother carries GBS in the rectum or vagina. People who carry GBS typically do so temporarily--that is, they do not become lifelong carriers of the bacteria.

GBS carriage can be detected during pregnancy by taking a swab of both the vagina and rectum for special culture. Physicians who culture for GBS carriage during prenatal visits should do so late in pregnancy (35-37 weeks’ gestation); cultures collected earlier do not accurately predict whether a mother will have GBS at delivery.

A positive culture result means that the mother carries GBS--not that she or her baby will definitely become ill. Women who carry GBS should not be given oral antibiotics before labor because antibiotic treatment at this time does not prevent GBS disease in newborns. An exception to this is when GBS is identified in urine during pregnancy. GBS in the urine should be treated at the time it is diagnosed. Carriage of GBS, in either the vagina or rectum, becomes important at the time of labor and delivery--when antibiotics are effective in preventing the spread of GBS from mother to baby.

Most GBS disease in newborns can be prevented by giving certain pregnant women antibiotics through the vein during labor. Any pregnant woman who previously had a baby with GBS disease or who has a urinary tract infection caused by GBS should receive antibiotics during labor. Pregnant women who carry GBS should be offered antibiotics at the time of labor or membrane rupture.

Recently, the Centers for Disease Control defined a set of recommendations to treat GBS in pregnant women, hopefully to prevent the rare but very serious disease in newborns. The CDC has published an excellent online brochure, Group B Streptococcal Infections, which provides detailed information.

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