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New Group B Strep (GBS) trial may offer hope for reduction in neonatal injury
Group B streptococcus, also known as GBS, is a common infection which is carried by many women. In most cases, for the adult woman, it is harmless. However, when GBS is contracted by a newborn baby, it can quickly overwhelm their undeveloped immune system. Left untreated, it can cause life-threatening conditions, such as meningitis, septicaemia, pneumonia, sensory impairment such as blindness or deafness, and serious neurological injury such as cerebral palsy.
With timely diagnosis and treatment, most babies with GBS make a good recovery. As with any serious infection, early detection and swift treatment are the key to avoiding permanent injury.
What is Group B Streptococcus?
This is a common type of bacteria. Approximately 20% of people have it living in their body.
GBS bacteria can live in the vagina, which is why babies of mothers with GBS are particularly at risk, as they can come into contact with the bacteria after the waters break and during the birth process.
Approximately 1-2% of babies fall seriously ill as a result of an infection with sepsis, meningitis or pneumonia.
How can GBS be treated?
Antibiotics can be given in labour, and these can reduce the chance of a baby developing group B strep by 80 to 90%. However, currently antibiotics are only routinely given to mothers in labour where the mother has had a diagnosed GBS urine infection during pregnancy, rupture of her membranes (waters) before 37 weeks gestation, or within the broad spectrum antibiotics given to women undergoing a caesarean section.
How do I know if I’m carrying Group B Strep?
Women with group B strep generally have no symptoms. The only way to diagnose GBS is to have a test for the bacteria. An ECM or Enriched Culture Medium test can be carried out in pregnancy, usually at approximately 35 to 37 weeks gestation.
What are the potential complications of GBS infection for the baby?
These can include:
- Blood poisoning (septicaemia)
- Lung infection (pneumonia)
- Brain lining infection (meningitis)
What are the long-term implications of the infection?
A child who suffers with a group B strep infection can be left deaf, blind or with significant learning difficulties. In some cases cerebral palsy and a significant brain injury can be diagnosed, and sadly in some cases the infection can prove fatal.
Is the test given as standard?
No. However, a trial is currently underway funded by the National Institute of Health Research to look at whether a regular test can improve the prevention of early onset group B streptococcal infections in babies.
The current approach to group B strep is to identify pregnant women who have risk factors for a baby developing an infection. The trial will compare this standard approach to proactive testing at 35 to 37 weeks, to identify pregnant women who actually carry the bacteria.
The trial will cost approximately £2.8m and be held across 80 hospitals through England, Wales and Scotland. The hope is that the results will inform future health policy in relation to management and prevention of early onset GBS in the UK.
What does the current research show?
In 2017 the Royal College of Obstetricians & Gynaecologists (RCOG) carried out a study which indicated that one in 1750 newborn babies developed a streptococcus infection. One out of 19 of those would die, whilst one in 14 would survive but be left with a long-term disability.
Naturally, these figures give rise to considerable concern about the dangers of group B strep to pre-term/newborn babies. Since 2000 there has been a rise of almost a third in the rate of group B strep infections in babies under three months. Data obtained to date shows that 65% of UK newborns who develop a group B strep infection, have mothers who did not demonstrate any risk factors. Whereas, 70% of those who do demonstrate risk factors, don’t carry the bacteria and are therefore unnecessarily given antibiotic therapy.
What will the trial involve?
The trial will include a trial of two different tests. One will involve a test during pregnancy at 35 to 37 weeks, where a sample will be taken to a local laboratory for processing. The other test will be a bedside test which is undertaken at the start of labour.
What is the aim of the research?
The hope is that the information from this trial will lead to improvements in early detection and treatment and the reduction in incidents of group B strep.
Researcher Professor Jane Daniels who is co-leading the trial has said that the aim of the review will be to “Answer the question for the NHS as to whether a test for pregnant women for GBS should become standard, and if it is going to proceed, whether it is best to do a culture test or a bedside test”.
Boyes Turner’s birth and neonatal brain injury specialists have recovered substantial compensation for children whose brain injuries and devastating disability were caused by delays in diagnosis and treatment of early onset GBS infection. We welcome this research and await its findings, in the hope that fewer babies will be injured by this serious disease.
If your child has suffered serious neurological injury from medical negligence then contact our expert team by email firstname.lastname@example.org.
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