Group B Streptococcus and Pregnancy

It is sometimes hard to believe that in the western world with all its modern medical technology, we still experience infant mortality.

We can now check the fetus when it is just a few weeks old, follow it throughout the pregnancy, sometimes check the amniotic fluids and the genes, measure, weigh, and listen - and still some babies are born seemingly healthy but their situation deteriorates within a few days, and very quickly, causing mortality.

The reason for some of these deaths, scientists say, is Group B Streptococcus. A bacteria.

The Strep B Bacteria Family

The Streptococcus bacteria family is not what you would call a nice family. They are squatters, enter the way they want, form a chain and colonize where they’ve landed. In the process, they cause problems that result in infections.

Cousin A (scientifically all the cousins are called groups) for example, can cause tonsillitis, scarlet fever, rheumatic fever, pneumonia, ear infections, and some more undesirable ailments.

Group B causes pneumonia and meningitis in newborn, in people with compromised immune systems, and the elderly.

Group C causes infections in horses.

Groups D, F, G, H exist as well and colonizes organs in humans, horses, and canines.

Group B Streptococcus (GBS) was recognized as causing problems in cattle in late 1880 when cows went ‘dry’, but its significance in humans was not discovered until 1938.

It took 22 more years for Group B Streptococcus to be recognized as the main cause of neonatal infections.

How Does One Get Infected with Group B Strep While Pregnant?

Not to be confused with Guillain-Barre Syndrome which is an autoimmune disease, GBS is not a sexually transmitted disease and not transmitted by food or water. Most of the time GBS is a harmless commensal - one organism benefits from the other without affecting it. You can carry GBS in your body for just a short period of time, it may come and go, or you can always have it.

This bacterium can be part of the flora that populates the gastrointestinal, the rectum, and genital tract of about 30% of healthy adults. In different studies, GBS vaginal colonization rate ranged from 4% to 36% with most studies reporting rates of over 20% in women that did not show any symptoms.

That’s why it was so difficult to understand this bacteria’s behavior because most of us have it at some period of our lives.

But these opportunistic harmless bacteria can, in some circumstances, cause severe invasive infections and serious illness for the mother and the baby during gestation and after delivery.

How Group B Strep Affects Pregnancy

Heavy GBS vaginal colonization can cause infections in the mother resulting in an intra-amniotic infection or severe infection of the placental tissues. Sometimes GBS urinary tract infections may induce labor and cause premature delivery.

By far the biggest problem is that women are not aware of this simple bacteria and the damage it can cause.

There are symptoms that may indicate you are at a higher risk of delivering a baby with GBS

• Labor or rupture before week 37
• Ruptured membranes for 18 hours of more before delivery
• Fever during labor
• Urinary tract infection during pregnancy as a result of GBS
• A previous baby with GBS

The Center for Disease Control and Prevention recommended routine screening for vaginal strep B for all pregnant women.

How Does GBS Affect the Newborn?

The stress birth inflicts on the vaginal walls make those colonies break away and wander, most of the time attaching themselves to the fetus as it makes its way through the birth canal. The statistic shows that 1 in every 2,000 babies in the United States is born infected with GBS.

Not every baby born to a mother who tests positive for GBS will become ill.

There are 2 different types of GBS in newborns:

Early onset – occurs within the first 7 days

Late onset – Occurs from the first week through 3 months.

The early onset disease, GBS most commonly causes sepsis (blood infection), pneumonia and sometimes meningitis.

Late-onset GBS causes sepsis, seizures, and mainly a quick deteriorating meningitis.

The risk factors for the late onset GBS disease are not as well understood as those for early onset disease.

According to the CDC in the US, GBS bacteria are the leading cause of meningitis and sepsis in the newborn’s first week of life.

About 1 out of every 4 pregnant women carries GBS bacteria in the rectum or vagina.

What Can We Do?

Most early-onset GBS disease in infants can be prevented by giving women antibiotics during labor. It can be only administered during labor and can’t be taken before labor because the bacteria can grow back quickly.

A pregnant woman who tests positive for group B strep bacteria and gets antibiotics during labor has only a 1 in 4,000 chance of delivering a baby who will develop GBS disease, compared to a 1 in 200 chance if she does not.

Any pregnant woman who had GBS in her urine during pregnancy should get antibiotics during labor.

A study into the effects of antibiotics during labor found that much of the good bacteria that is normally found in the flora of the newborn is absent.

The stories are heartbreaking. You can see some of them here. This heartbreak for something that could probably have been easily avoided.

The Best Treatment is, of course, Prevention.

There are numerous studies on the effect of probiotics on the vaginal flora. One study checked the impact of prenatal probiotics on Group B Streptococcus colonization. It concluded that a daily dose of probiotics that includes Lactobacilli and Bifidobacterium, among other things, can reduce the colonization of GBS. “High numbers of lactobacilli may contribute to a low vaginal pH and seem to have a negative influence on Group B streptococci,” Another research says.

Therefore, replacing vaginal normal flora using probiotic is recommended to prevent GBS infections in mothers and their newborns.

As for taking supplements during pregnancy? There was no evidence of any negative side effects on the pregnant mother. On the contrary, about 50% of the women reported improved digestive process and less urinary tract infections.

 

The Flora Bloom by Intimate Rose is suitable for pregnant women, the inclusion of lactobacillus probiotics may help to prevent Group B Strep infection which is one of the most common causes of neonatal sepsis and meningitis.