The Royal College of Obstetricians and Gynaecologists (RCOG) has updated its clinical guidance on when to give pregnant women antibiotics for Group B Streptococcal (Group B Strep) infections. The amended guidance recommends that all women who go into labour before 37 weeks of pregnancy, regardless of whether their waters have broken, should be offered antibiotics to prevent the onset of infection and highlights other risk factors for Group B Strep which include prolonged rupture of membranes; a temperature of more than 38 degrees during labour; a positive test for Group B Strep discovered incidentally during pregnancy, and already having a baby who has been affected by Group B Strep.
Group B Strep is the most frequent cause of severe, early onset, infection in babies who are less than seven days old. The bacteria occurs naturally in the mother’s digestive system and lower vaginal tract; it is normally not harmful to her. One in four women will have this bacteria at any one time but, since it does not produce any symptoms or side effects, they are usually unaware that they are infected. The bacteria can be passed onto the baby during labour and, although most babies do not suffer any ill effects, a small proportion will go on to develop the infection.
Worryingly, the RCOG says that the incidence of early onset Group B Strep appears to be rising in the UK. Although many of these babies will recover fully if treated promptly, babies born pre-term are at a higher risk of developing Group B Strep than those born at term. While the risk for babies born at term is 1 in 2000, for pre-term infants, the figure is 1 in 500.
The updated RCOG guidelines also recommend that, in order to manage the risk of passing Group B Strep onto the baby, a test should be offered to those women between weeks 35 and 37 of pregnancy who have been identified as a carrier from a previous pregnancy. Pregnant women should also be provided with information about Group B Strep in order to raise awareness.
Jane Plumb, CEO of Group B Strep Support, says: “We welcome this major update to the RCOG’s clinical guidance which represents a significant improvement in the procedure to prevent Group B Strep infection in new-born babies. When fully implemented across the UK, we believe this change will make a real difference and we will start to see a fall in the rate of infections.”
Camilla Wonnacott, associate in the clinical negligence team at Penningtons Manches, commented: “Sadly, we do see cases where, when Group B Strep is left untreated, infants go on to suffer life-changing injuries or lose their lives. If you or your baby has suffered as a result of delayed diagnosis or negligent treatment, our specialist team may be able to help and would be happy to have an initial, no obligation conversation to discuss your concerns.”