Do you know Group B Strep?

Jessica Stewart-Gonzalez: [00:00:00] Welcome to the Parenting Brief. I’m your host, Jessica Stewart-Gonzalez, an Arizona working mom and chief of the Office of Children’s Health at the Arizona Department of Health Services. We’ve got you covered with expert tips and advice for those that are pregnant and for parents with kids under five.

If you’re pregnant or have been pregnant, you have probably heard about Group B strep. Adults don’t have symptoms, but when it comes time for delivering baby, it could cause some health issues. For your new little one, we’re here to talk about how to find out if you have it and what it means for parents.

We’re here with Dr. Sarah Sams, she’s a family physician and a member of the Board of Directors of the American Academy of Family Physicians with lots of knowledge and experience on Group B Strep. Thanks for being here. 

 Dr. Sarah Sams: Thank you so much for having me. 

Jessica Stewart-Gonzalez: So [00:01:00] let’s just start by talking about what is Group B strep?

 Dr. Sarah Sams: Well, uh, group B strep is one of the forms of streptococcal bacteria that is common in all of our bodies. Most people have group B strep in their intestinal track, and it doesn’t affect us in any negative way. However, there are about 25% of women will have group B strep in their vagina. Again, doesn’t affect them if they’re not pregnant, but can cause problems for the baby if the baby picks it up through the birth canal.

Jessica Stewart-Gonzalez: Are there ever any signs and symptoms of group B strep for mom? 

 Dr. Sarah Sams: Not really. Sometimes because of the proximity, a woman might get a group B strp urinary tract infection, and then she’ll have symptoms of a urinary tract infection, which we would treat because of her symptoms. And that’s just an indication that it’s probably in the vagina, uh, because the urethra is really close, [00:02:00] um, and can be cross-contaminated.

Jessica Stewart-Gonzalez: And then how would people know if their baby has it? 

 Dr. Sarah Sams: So babies will show signs of the infection either within the first couple of days in an early infection or up to several weeks later, and they might have symptoms like fever, difficulty feeding. They might be lethargic and not wanna wake up, be really tired, kinda inactive.

They may have difficulty breathing. Especially if they get group B strep pneumonia, you’ll see more of the respiratory symptoms and if they get the meningitis, you’ll get more of that lethargy and kinda lymph inactive feeling. 

Jessica Stewart-Gonzalez: Is it common protocol practice for, um, all women to be tested for group B strep prior to delivery?

 Dr. Sarah Sams: Yeah, we recommend that everyone be tested because it is a easy infection to treat preventatively, and it’s much [00:03:00] more difficult to treat the baby. Only about 1% of infants will actually get group B strep infection, but because the symptoms are so serious and because the preventative treatment is so simple to do and so safe, we feel like it’s um, much more cost effective and safe to test and treat those who are positive when they’re in labor.

Just to prevent that 1% case of an infant getting really sick. 

Jessica Stewart-Gonzalez: And what does that test and treatment look like? 

 Dr. Sarah Sams: So the test is simply a, a swab done with a culture tube. Um, it’s a little bit different than some of the other things that we do when we test in pregnancy because we do a swab inside the vagina and then down into the rectum.

And so I always caution patients before I do this, that this is gonna feel a little different than just the type of swabs we normally do for just cultures of the vagina. Um, as far as treatment, um, in somebody who’s [00:04:00] tested positive for group B strep, when the woman comes in in labor, we will put her on antibiotics.

Um, typically penicillin unless there’s an allergy to penicillin. And then we have alternatives to use, but simple, uh, antibiotic dosing with penicillin. Four hours apart. Um, we like to get at least two doses of antibiotics in before the baby’s born. And so it’s a very simple way to treat. 

Jessica Stewart-Gonzalez: And how far in advance of does that test happen?

Like mom’s in full labor, they’re going in to the hospital, let’s say. Um, and is that when that test is done or is that test done prior to that moment in order to know whether or not there is that risk at all? 

 Dr. Sarah Sams: We prefer to test, um, before the, they’re in labor. So we usually will test around 35 or 36 weeks gestation so that we know ahead of time.

And the reason that we test it at that point is we don’t know when [00:05:00] she’s gonna go into labor. And the test is. What we call valid for about four weeks. So we try and test about the time that, that, that four weeks would expire at the due date. Um, if they have a prolonged labor or prolonged delivery time, um, go past their due date.

We might have to repeat the test if it was done more than four to five weeks before. Um, but yeah, we like to try and test. Ahead of time so that we can plan for the antibiotics and know that we’re going to do that when the patient comes in in labor and let them know it as well. 

Jessica Stewart-Gonzalez: Is it possible to contract group B strep after that test is done?

 Dr. Sarah Sams: It is certainly possible, um, but it’s less likely, um, be because if they haven’t had it up to that point, it’s probably not gonna spread to the vagina. Like I said, about 25% of women just have that in their vagina all the time and. It doesn’t cause any symptoms and they would never know it. So we’re [00:06:00] mostly just testing to see if, if they’re what we call a colonizer or somebody that just sort of harbors that bacteria.

Um, but it is possible that it can be picked up and that’s why if it’s been more than four weeks, we’ll test again just to make sure that they haven’t subsequently picked up that infection. 

Jessica Stewart-Gonzalez: We know that most people have some sort of a birth plan, so how does it impact the birth plan or what should moms be including in their birth plan, um, as it relates to group B strep?

 Dr. Sarah Sams: Well, one of the things that we want to do is make sure we get those two doses of antibiotics in before we break water, if possible. So assuming that they have not come in with spontaneous rupture of their membranes, um, we try and delay rupture of membranes until after they’ve had that second dose of antibiotics.

So if they’re being induced for some reason, we again, plan for that and say, let’s get those antibiotics on board before we really get aggressive with the induction plan. Um, if they’re coming in, in [00:07:00] spontaneous labor, again, we try to get that second dose in and not hurry along the delivery until after they’ve had that second dose.

That doesn’t always work. ’cause sometimes our bodies just do what they wanna do and, and have fast labors. Um, but even if we can just get the first dose in, that’s better than none at all. 

Jessica Stewart-Gonzalez: Where is the best place to go for more information on Group B Strep and as they are, um, preparing for that delivery?

 Dr. Sarah Sams: The American Academy of Family Physicians has a patient information site called family doctor.org, and we’ve got a lot of great information about all sorts of different things, not just about Group B strep, but that’s a good place to go. The American College of OB, GYN also has information and the pediatric society would as well because it does affect babies.

Jessica Stewart-Gonzalez: We have more resources on Group B [00:08:00] Strep. In the episode show notes. Make sure to follow the show so that you never miss an episode. Until next time, this is Jessica. You’ve got this.