Group beta strep (GBS):
by Lauren Feder, M.D.

What is GBS?
Group Beta Streptococcal (GBS) is a bacteria that normally resides in the intestinal tract of healthy adults.  It is different from the bacteria that causes strep throat, which is known as Group A Streptococcus. GBS is the most common cause of life threatening infections in newborn babies affecting approximately 0.5% of infants born to GBS positive mothers. or 12,000 infants yearly in the United States.  Nowadays, many practitioners routinely screen for GBS by  swab culture taken  from the vagina or rectum.  In general, 30% of women are found to be carriers.  GBS infection in newborns usually occurs within the first seven days of life and can lead to pneumonia, meningitis, or systemic blood infection (sepsis).  The American College of Obstetricians and Gynecologists (ACOG) have recommended that all pregnant women be tested for GBS between weeks 35 and 37, and women who test positive be given intravenous antibiotics, such as penicillin, during labor. 

Reasons to consider the GBS test and antibiotic treatment
•Sometimes, the bacteria can be passed to the baby during birth, leading to infection.
•Fever during labor increases the chance of GBS infection
•Premature delivery or rupture of membranes (water breaking) before 37 weeks. increases the risk of GBS
•If a woman experiences her water breaking for more than 12 hours without delivery.
•Women who already have tested positive for GBS in previous births

Risk of GBS screening and treatment
•Concerns have been raised over the use of antibiotics and potential contribution to antibiotic resistance in newborns.
•Studies on newborns with GBS infection have not been convincing..  A high percentage of newborns hospitalized with GBS sepsis infections were born to mothers who received antibiotics during labor
•While some studies show a decrease in incidence of the disease in newborns, the number of deaths remain unchanged.
•Research has also shown that while antibiotics may reduce GBS infection in newborns, there is a susceptibility to other superbugs leading to increased  antibiotic resistance and risk of other severe illnesses such as systemic blood infections (sepsis). 
•Common side effects of antibiotic use include yeast infections such as thrush in both mother and baby which  can interfere with breastfeeding.
Despite this information, there are women who decline the GBS testing or antibiotics altogether. The decision is based on several factors including the fact that a positive culture for GBS in the vaginal area does not accurately predict the incidence of the disease in the newborn. In general, GBS is rare if there are no high risk factors at birth.  Although there is not much research on alternatives to antibiotics, many midwives and alternative practitioners recommend the use of natural supplements that may help reduce the colonization of GBS in the vagina and boost the immune  system:  Be sure to discuss alternative treatments with your practitioner, some women begin boosting the immune system prior to the GBS test which may help or reduce or eliminate the colonization of GBS.