Group B Streptococcus (GBS)


Group B Streptococcus (GBS)

What is GBS?

GBS is one of many kinds of bacteria that normally live in our bodies in both men and women. Most people who have GBS have no symptoms and it is not usually harmful, to the majority of people. 10% to 35% of pregnant women will have GBS in their vagina and/or rectum at any time. GBS is a type of bacteria that lives in our bodies at different times. If we test different people to see if the bacteria is there over a certain time period, we might find it is always there, never there, or sometimes there.

  • Because GBS is transient, there may be ways that we can prevent having GBS in our bodies, especially around the time of labour and childbirth

When is GBS tested during pregnancy?

  • At 35 to 37 weeks of pregnancy, you will be offered a test for GBS.

  • The test for GBS involves passing a cotton swab, like Q-Tips, inside your vagina and rectum. The swab is then sent to a lab for testing.

  • If your test shows you carry GBS, you are considered GBS positive. If you test shows you do not carry GBS, you are considered GBS negative.

What could GBS mean for my baby?

The presence of GBS in the mother means that there is a risk that the baby exposed to GBS during labour and birth may develop an infection. GBS may cause sickness in babies within the first seven days of life (called early-onset disease) or after 7 days (called late-onset disease). GBS can cause bacteria to enter the blood (bacteremia), lung infection (pneumonia), inflammation in the brain and spine (meningitis), respiratory infections and death.

One study showed that 30%-50% of infants with early-onset GBS disease had long-term problems (this means 50% to 70% of infants with early-onset GBS disease had no long-term problems). Some babies with early-onset GBS disease may have long-term effects such as mild to severe delays in mental function (cognitive delays), paralysis of all four limbs (quadriplegia) or deafness.

How does a GBS positive test affect how my labour and birthing is managed?

Once a woman has a positive GBS during her pregnancy, her official GBS status is positive, even if she has another negative test.

With a GBS positive test result:

The woman is most commonly offered IV antibiotics during her labour every 4 hours. Penicillin is the antibiotic most effective against GBS, but alternate antibiotics can be used if the woman is allergic to penicillin.  You can discuss with your healthcare provider your options around active or expectant management of GBS during labour.

The woman may be instructed to go to the hospital earlier compared to a GBS negative woman. For example, you will be instructed to go to the hospital or see your midwife to receive IV antibiotic once your water breaks even if you aren’t experiencing labour contractions yet.

The woman may be given a shorter amount of time to labour compared to a GBS negative woman, especially if her water breaks earlier in labour.

Your baby may require additional monitoring after birth to assess for possible early and late onset GBS infection.

Antibiotic use during labour and birth

A main concern during childbirth is infection of the baby and of the mother and often antibiotics are administered in GBS positive women, and in other laboring situations. While there may be valid medical rationale for antibiotic use, we are just beginning to understand the consequences of this practice. One of the benefits of being vaginally born is that the baby is exposed to the vaginal flora of the mother. This flora is the seeding microflora for the baby’s gut and immunity and serves to establish that baby’s microbiome for life – an important realization that current science and medicine is starting to understand. This also explains why there are potential health differences between baby born vaginally and babies born via c-section.

Once a woman tests positive for GBS, it is important for her to follow the medical advice of her healthcare provider. Therefore, the way to avoid antibiotics during labour is to prevent a positive GBS test in the first place.

Naturopathic medicine and GBS

Naturopathic medicine can play a key role in this area by helping the mother take steps to prevent a positive GBS test. A consult with the naturopathic doctor will include a review of your diet, supplements and personal health history that can help identify potential risk factors. She can make recommendations to help balance and strengthen your immune system, optimize your body’s own microbiome and help you maintain a healthy and worry-free pregnancy which will help increase your chances for a worry-free labour and childbirth.

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Photo credit: Bahasa Indonesia: gambaran coccus-ungu pada SGB,  Nurul hanifah 111, 26 June 2012

Jonah Arnold