Group B Strep (GBS)
Group B Strep (GBS) is a bacterium that is the most common cause of life-threatening infections in newborns. Approximately 2,000 babies acquire serious GBS disease in Canada each year, and up to 200 of these babies will die. Many of those who survive will suffer from permanent brain damage, resulting in hearing or vision loss, learning disabilities, or cerebral palsy.
What causes Group B Strep?
GBS is found in the vagina and/or lower intestine of 10 to 35 percent of all healthy adult women. GBS does not generally cause active infection, and it is not contagious. However, during labor and delivery, babies can be exposed to GBS in several different ways. The bacteria can travel upward from the mother’s vagina into the uterus once the membranes (bag of waters) rupture. Further, babies can be exposed to GBS while passing through the birth canal. The bacteria can be swallowed or inhaled by the baby during this time. It may also be possible that GBS may cross intact membranes to expose the baby while it is still in the womb.
How do babies get sick from Group B Strep?
In some of cases, GBS gets into the baby’s bloodstream, which can result in sepsis (an overwhelming infection that spreads throughout the body), pneumonia, or meningitis, potentially leading to a lifelong disability and, in some cases, death. Approximately 75 percent of cases of GBS disease in newborns occur during the first week of life, and most cases appear within a few hours after birth. This is referred to as “early onset” disease. Although premature babies are at higher risk for GBS disease, and, if infected, are at higher risk for serious long term complications or death, full term babies account for 70 to 75 percent of GBS disease in newborns. Some infants develop GBS from one week to several months after birth. This is referred to as “late onset” disease. Approximately one-half of these cases are related to the baby’s mother being colonized with GBS. The source of GBS in the remaining one-half of late onset disease is unknown.
What are the long term effects of GBS disease?
A child with GBS disease may suffer permanent brain damage, leading to hearing or vision problems, learning disabilities, or motor deficits. For a more detailed discussion, visit our page on cerebral palsy.
How is GBS disease diagnosed and treated?
GBS disease should be considered in any newborn baby who demonstrates sign or symptoms of infection at birth or during the first week of life. The symptoms may include fever, breathing difficulties, grunting sounds, increased (stiff or decreased) limp, muscle tone, seizures, or markedly unusual behavior.
If any of the above symptoms are present, blood tests and cultures of bodily fluids such as urine, sputum, or cerebrospinal fluid are performed to check for the presence of GBS. It generally takes several days to obtain the final results of these tests. However, intravenous antibiotics would routinely be started immediately once GBS disease is suspected.
Can GBS in newborns be prevented?
70 to 80 percent of cases of GBS disease in newborns can be prevented by administration of intravenous antibiotics to the mother at the onset of labor in those cases in which one or more risk factors are present. These include the following:
- Positive culture of the mother for GBS colonization at 35-37 weeks
- Previous baby with GBS disease Urinary tract infection due to GBS
- Fever (temperature higher than 100.4 degrees F) during labor
- Rupture of membranes (breaking of the bag of waters) 18 hours or more before delivery
- Labor or rupture of membranes before 37 weeks
If one or more of these risk factors are identified, intravenous antibiotics should be offered to the mother as early in labor as possible. It is medically appropriate to perform cultures of the mother’s vagina and rectum between 35 and 37 weeks to check for GBS colonization. If a culture has not been done, or the results are not known, antibiotics should still be offered to the mother if her membranes rupture 18 hours or more before delivery, or if she has the onset of labor and/or rupture of membranes before 37 weeks. The antibiotics most commonly given are Penicillin or Ampicillin.
Seeking Legal Help
If your child has suffered from Grade B Strep and you suspect that the injury resulted because a doctor, nurse, or other health care provider failed to provide adequate care during the pregnancy, during the labor and delivery of your baby, or after your baby demonstrated symptoms associated with GBS, you should immediately contact a competent lawyer. The lawyer will be able to help you understand whether your child’s injury was the result of a health care provider’s negligence, in which case the lawyer will also be able to assist you in recovering compensation that can be used for your child’s care and education.