Issue link: https://cp.revolio.com/i/855118
If a pregnant woman carrying GBS is not treated with an bio cs during labor, the baby's risk of becoming colonized with GBS is approximately 50%. Note that most colonized babies do not develop GBS infec on. The risk of a baby developing a serious, life-threatening GBS infec on, according to the Centers for Disease Control and Preven on (CDC), is 1 to 2%. The mortality rate (number of babies that die) with early onset GBS infec on is 2 to 3% for full-term infants (I know that sounds low, but as I always tell my pa ents, it's 100% if it's your baby), and as high as 20-30% for premature infants (born earlier than 33 weeks gesta on). Over 1600 cases of early-onset infec ons occur in newborns annually, with about 80 deaths per year, despite an bio c prophylaxis in labor. GBS infec on in the newborn can lead to very long stays in the NICU (Neonatal Intensive Care Unit,) and up to 44% of infants who survive GBS meningi s end up with long-term health problems, including developmental disabili es, paralysis, seizure disorders, hearing loss, and vision loss. If a GBS posi ve woman is treated with an bio cs during labor, her infant's risk of developing early onset GBS infec on decreases by about 80%. There are no sta s cs on the percentage of babies exposed to an early an bio c that will develop short, or long-term consequences such as allergies, asthma, obesity, or diabetes. How & When Does GBS Infection Occur in the Baby? Infec on is categorized in two ways, either early or late onset GBS infec on. Symptoms of early-onset disease occur within a few hours of the birth, and up to a week a er. In one large study, as cited by Rebecca Drekker, PhD of Evidence Based Birth, of 148,000 infants born between 2000 and 2008, nearly all of the 94 infants who developed early GBS infec on were diagnosed within an hour a er birth – sugges ng that early onset GBS infec on probably begins even before birth. An bio c prophylaxis (preventa ve treatment) given to the mother during labor is used to prevent early-onset infec on. Late-onset disease develops through contact with hospital nursery personnel and usually manifests in the first 3 months a er birth. Up to 45% of health care workers carry the bacteria on their skin, and may transmit the infec on to newborns. Me culous hand-washing prac ces in the hospital are essen al for preven on of infec on transmission. What Women Get GBS? & Which Babies Get GBS Infection? While any woman can be colonized by GBS, some seem to be more at risk. This includes women under 20 years old, women with mul ple sexual partners and regular tampon users. Frequent sex, or sex close to the me you get tested, oral sex (ge ng it, not giving it), and infrequent hand washing are also associated with a greater likelihood of a posi ve GBS test. For some reason I cannot explain, African-American women are also more likely to be colonized by GBS. New research coming out on the microbiome does suggest that disrupted gut microflora may play a role in GBS coloniza on. I discuss this in a minute. While any baby can develop GBS infec on if the mother is colonized, the following factors increase a baby's risk: birth prior to 37 weeks, African-American descent, high temperature in the mom during labor, rupture of membranes before entering labor, a prolonged me between membrane rupture and birth, chorioamnioni s (infec on of the membranous sac surrounding the baby), intrauterine monitoring during labor. What Testing is Recommended & Is It Reliable? The gold standard test used in screening for GBS is a bacterial culture of a sample collected from a simultaneous vaginal and rectal swab done by your obstetrician, family doctor, or midwife. The best me to test for the presence of the organism is between the 35th and 37th weeks of pregnancy. Tes ng, at this me, is as much as 50% more effec ve at predic ng and preven ng perinatal disease than screening earlier in pregnancy, although the numbers of organisms in any individual might fluctuate, making detectable levels variable. CDC guidelines published in 2002 recommend universal screening for pregnant mothers between 35 and 37 weeks gesta on. Page 58 | Abby's Magazine - www.AbbysMag.com