Strep B In Pregnancy

1. What is Strep B?

Group B Streptococcus lives quietly in most of us and we show no signs of infection from the organism. Doctors don’t consider someone who tests positive for the Strep B bacteria to have an infection.

Women may not realize they carry the organism since they don’t show any symptoms for it. Strep B is often found in the vaginal or rectal areas, which makes the bacteria easily picked up by a baby in a vaginal birth.

2. What role does Strep B play in pregnancy and delivery?

For reasons we do not know, some babies become very sick when exposed to the Strep B bacteria in the birth canal.

Because Strep B is so common, the American Academy of Obstetricians and Gynecologists (ACOG) doesn’t treat Strep B in early pregnancy. ACOG believes the infection will simply reoccur before delivery even if the mother is given antibiotics to treat the organism. Therefore, ACOG recommends putting off screening mothers for Strep B until the 36th or 37th week of pregnancy. If the mother has Strep B at that time, the ACOG protocol is to administer IV antibiotics during labor.

3. What is the problem with waiting until you are 36 or 37 weeks pregnant to test for strep B?

The present ACOG recommendation is based upon what I consider to be a mistaken belief that the Strep B organism lives only on the space of skin, between a woman’s vagina and anus (perineum) and in the vagina itself. New studies show that this organism can move upwards into the uterus and result in either preterm birth or stillbirth.

I always tested my pregnant patients for Strep B early in their pregnancy and I treated my patients and their partners with antibiotics. It’s true that sometimes the patient might become reinfected with Strep B again, but I knew from experience that many of the patients who came to me had had repeated miscarriages. Once I treated them for Strep B, they often had successful pregnancies.

4. What is the treatment for Strep B?

Penicillin is the treatment of choice for group B strep. For women who are not allergic to penicillin, it is as safe as water in pregnancy. If you are allergic to penicillin, erythromycin, or some member of its family is a safe alternative.

5. What is the danger of Step B for my baby?

Most babies who are infected with Group B don’t become sick, but for reasons we do not understand, some babies become very ill with exposure to Strep B. If a baby becomes sick with Group B, they can develop pneumonia at birth or in the month following their birth, or they can develop meningitis at about three months after birth. There is a common belief that a baby who develops pneumonia with Strep B won’t develop meningitis later, but I have known of babies who had both.