Prenatal-onset Group B Strep (POGBS) Disease: Giving a Name to Group B Strep DiseaseAcquired before Birth and Four Courses of Action to Help in Its Prevention
Group B strep (GBS) can definitely infect babies before birth, yet there is not an official name designated for GBS disease when it causes babies to be miscarried or stillborn. To further awareness and prevention of GBS disease in all stages of a baby’s development, Group B Strep International is giving a name to GBS disease acquired before birth: Prenatal-onset Group B Strep (POGBS) Disease.
Most medical literature mentions only two types of GBS disease: early-onset and late-onset. The majority of known GBS infections in newborns occurs in the first week of life. These GBS infections are designated as early-onset GBS (EOGBS) disease. So far the primary focus of GBS disease prevention has been treating GBS positive women during labor so that their babies do not become infected during passage through the birth canal. Currently both the United States and Canada have active prevention guidelines in place to test all pregnant women at 35-37 weeks of pregnancy and, if positive, treat them with IV antibiotics during labor. These guidelines have been very successful in reducing the rate of early-onset infection by more than half from 0.7 cases per 1000 live births in the U.S. in 1997 to 0.32 cases per 1000 live births in the U.S. in 2004.1
Currently the secondary focus of GBS disease prevention is late-onset GBS (LOGBS) disease which occurs in infants over 1 week of age usually up to the first three, but sometimes even six months of life. LOGBS can be caused by sources other than the mother, including hospital personnel. Prevention consists mainly of promoting thorough hand washing prior to anyone handling the baby and breastfeeding to give the baby important antibodies. Recognizing symptoms of GBS infection can result in better outcomes for the baby if prompt medical treatment is initiated.
However, a baby can definitely succumb to GBS infections long before the bacteria are transmitted during delivery. Since this is not yet a recognized disease it is unknown how many babies have been miscarried or stillborn due to GBS. Pathology testing is not mandatory and not even always suggested to the mother. At minimum, placental culturing may tell the cause of death. This is important especially since having a baby infected by GBS puts a mother at higher risk for subsequent babies being infected by GBS.
Perhaps the reason that prenatal-onset GBS disease has not been officially recognized is that the general medical opinion considers GBS-caused miscarriages and stillbirths to be rare occurrences. However, among GBS awareness groups, there are far too many parents who have had their baby’s autopsy or placental testing report cite GBS as the cause of death for prenatal-onset GBS disease to continue being regarded as rare.
Fortunately there are at least four main courses of action to help prevent prenatal-onset GBS disease:
Current protocol actively addresses early-onset prevention. However, prevention of prenatal-onset GBS and recognition of symptoms of GBS infection in babies once born can further reduce the effects of GBS disease in babies before and after birth. For symptoms including fever, lethargy, and any kind of distress in the baby, please visit http://www.groupbstrepinternational.org/brochure.html. GBS information is available in both English and Spanish.
Group B Strep International (GBSI) is an organization formed to promote awareness and prevention of Group B Strep disease worldwide. To further these efforts GBSI is sponsoring International Group B Strep Awareness Month in July as an official observance on the 2007 National Health Observance Calendar.
Please join us at www.groupbstrepinternational.org in the fight against GBS disease before and after birth.
Your comments and feedback are appreciated. Please feel free to e-mail us at firstname.lastname@example.org
This article is for informational purposes only and does not constitute medical advice.
2. Morbidity and Mortality Weekly Report, Prevention of Perinatal Group B Streptococcal Disease Revised Guideline from CDC, Centers for Disease Control and Prevention, Vol. 51, No. RR-11. August 16, 2002.
3. McGregor, James A., MD, CM, “Group B Strep: A Patient/Provider Approach for Optimizing Care.” www.OBGYN.net
4. Kurt Benirschke and Peter Kauffman, “Pathology of the Human Placenta, Third Edition."
5. DeMott, K., “Cervical Manipulations Linked to Perinatal Sepsis: Consider GBS-specific Chemoprophylaxis (Eight Case Reports).” OB/GYN News, Oct. 15, 2001.
6. Cohen, Arnold W., MD, Goldberg, Jay, MD, MSCP, “Membrane Sweeping and GBS: A litigious combination?” OBG Management, Sept. 2006, Vol. 18, No. 9.
7. McGregor, James A., MD, “Infection and prematurity: the evidence is in,” Medical Tribune Opinion, Feb. 6, 1997.
8. Antimicrobial therapy for obstetric patients. ACOG educational bulletin no. 245. Washington, D.C.: American College of Obstetricians and Gynecologists, March 1998;245:8-10.
9. Bland ML, Vermillion ST, Soper DE, “Late third-trimester treatment of rectovaginal group B streptococci with benzathine penicillin G.” Am J Obstet Gynecol. 2000 Aug;183(2):372-6.
10. Weeks JW, Myers Sr, Lasher L, Goldsmith J, Watkins C, Gall SA., “Persistence of penicillin G benzathine in pregnant group B streptococcus carriers.” Obstet Gynecol. 1997 Aug;90(2):240-3.
11. Pinette MG, Thayer K, Wax JR, Blackstone J, Cartin A., “Efficacy of intramuscular penicillin in the eradication of group B streptococcal colonization at delivery.” Matern Fetal Neonatal Med. 2005 May;17(5):333-5.