You can get more information at
the following websites:
Who is at risk of passing on
GBS to their baby;
Premature babies born before 37 weeks of
pregnancy but especially before 35 weeks may
be more at risk.
If your waters break and you do not go
into labour for 18 hours or more your baby
may be more at risk.
Women who have had a previous baby
with GBS disease may be more at risk for
this to happen again.
If you have a fever of more than 38 degrees
centigrade in labour you may be at risk.
If GBS is found in your urine during
pregnancy you may have a higher risk.
If you are a young, under 21 years, first
time mother you may not have as many
antibodies in your body to fight GBS
If you have any of the above risk factors you
may also want to consider the following;
Having vaginal examinations may increase
the risk of taking GBS into the vagina especially
if your waters have already broken.
Having internal monitoring of your baby
(with a clip on baby’s head) during labour,
particularly if there are other risk factors
present, may increase the risk of infection.
NB If the circumstances warrant it these
procedures may be advised despite the small
risk of GBS.
NB. The risk increases the more of these risk
factors you have. Some factors have a higher risk
than others,. For some, more that one factor is
needs to be present for there to be a significant risk
to the baby.
Group B Streptococcus
New Zealand Medical Journal:
https://www.nzma.org.nz/journal/117-1200/1023/
NZCOM Consensus:
http://www.midwife.org.nz/index.cfm/3,108,271/group-b-
strep-nzcom.pdf Implications for pregnancy
RANZCOG:
http://www.ranzcog.edu.au/publications/statements/C- and the newborn baby in
obs19.pdf
UK GBS: www.gbss.org.uk Aotearoa/ New Zealand.
USA GBS: www.groupbstrep.org
References:
Campbell N, Eddy A, Darlow B, Stone P, Grimwood K.
The prevention of early-onset neonatal group B
streptococcus infection: technical report from the
New Zealand GBS consensus working party. N Z
Med J 2004;117(1200):U1023.
Grimwood, K., Darlow, B.A., Gosling, I.A., Green, R.,
Darlow, B.A., Lennon, D.R., Martin, D.R. Late ante-
natal carriage of group B Streptococcus by New Zealand
women. Australian and NZ Journal of Obstetrics and
Gynaecology, 43, (2), 182-186
Green, R., Lennon, D.R., Martin, D.R., Stone, P.R.,
(2002). Early-onset neonatal group B streptococcal
infections in New Zealand 1998-1999. Journal of
Paediatrics and Child Health, 38 (3) 272-277.
Kimura, K., et al. (2008). First molecular character of
group B Streptococcus with reduced penicillin sus-
ceptibility. Antimicrobial Agents and Chemo-
therapy, 52, (8), 2890-2897,
Mullaney, D.M., (2001), Group B streptococcal
infections in newborns. Journal of Obstetrics Gyne-
cology and Neonatal Nursing, 30 (6), 649-658.
Kenyon.,S.L., Taylor, D.J., Tarnow-Mordi, W., (2001).:
The Oracle II randomized trial. The Lancet. 357, 989
Author
-994. Carolyn McIntosh
Schuchat, A., (1998). Epidemiology of group B Midwife, 8 St Andrew Place
streptococcal disease in the United States: Shifting Balclutha
paradigms. Clinical Microbiology Reviews 11 (3), Email: cardacs@gmail.com
497-513
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pamphlet. Please attribute original to the author.  
Group B Streptococcus:
Group B Streptococcus is a bacteria which
is found normally in the human body. It is
usually found in the bowel but can also be
found in the vagina or urinary tract.
Women’s bodies naturally encounter Group
B Streptococcus and produce antibodies to
it. The more antibodies a woman has the
more protection she has against Group B
Streptococcus. This means women usually
have more protection as they get older.
Group B streptococcus can be found in
the genital tract in 10-30% of all
pregnant women.
Because of the low incidence of
Infection, and relatively high incidence
of colonization in New Zealand, it is not
recommended to screen all pregnant
women for Group B Strep [ Grimwood et al,
2002; Campbell et al, 2004.]
Group B Streptococcus is often referred to
as Group B Strep or GBS. Occasionally
GBS is an aggressive strain and causes se-
rious infection in newborn babies. When
this happens it is called Group B Strepto-
coccal disease of the newborn.
Group B Strep disease of the
newborn can either be;
Early onset disease, which develops in
the first 7 days of a baby’s life, but most
often with 24-48 hours.
or
Late onset, which is very rare, and
occurs between 7 days and 3 months of
age.
Rates of GBS disease;
1 out of every 2000 babies born in New
Zealand will have some Group B
Streptococcal disease.
1-2% of these babies will become
extremely sick and die.
This gives a total rate of babies who are
likely to die because of this disease of
about 1 of every 100,000 babies born in
New Zealand.
These figures indicate that the babies of
most women who carry GBS bacteria
will not become sick.
Signs of Group B Streptococcal
disease in Babies:
• Nostrils flare as the baby
breathes.
• Baby chest sucks in with
breathing.
• Baby makes grunting noises
with breathing.
• Baby has trouble keeping
warm.
• Baby might be sleepy and not
feed well.
• Baby might be pale and floppy
NB: The outcome for babies is
much better if they are treated
quickly so it is important that you
seek help for your baby if you have
any concerns or he/she displays any
of these symptoms
Antibiotics for GBS;
Women who are at increased risk of GBS
disease are offered antibiotics in labour
which will help to prevent GBS in 90% of
the babies who would become sick with
GBS. You will need to decide if you should
have these antibiotics and should discuss
this with your LMC.
Once labour is established antibiotics will be
given into a vein. If the woman is not
allergic to Penicillin then Penicillin G at a
dose of 1.2 grams will be given initially, and
every 4 hours afterwards 600 milligrams will
be given until the baby is born. It is best if the
antibiotics are given at least 4 hours before
the baby is born..
If the woman is allergic to penicillin
Erythromycin or Clindamycin will be given.
Problems with antibiotics;
About 1 in every 10 women will
experience a mild reaction to penicillin
for example a rash may develop. 1 in
every 10,000 women will have a severe
reaction or anaphylaxis; this is a serious
condition and can cause death in 1 in
50,000 to 1 in 100,000 women.
(Salkind,A.R., et al., (2001), JAMA 285. 2498-2505)
There is increasing concern about bacteria
becoming resistant to antibiotics. It is
estimated that if all women with risk factors
have antibiotics then 16% of all women in
labour will be given intravenous antibiotics.
Some strains of GBS are now known to have
reduced susceptibility to antibiotics (Kimura et al.,
2008) other bacteria which may also be present
in the woman’s system are developing
resistance. These bacteria could
cause increasing problems in the future and may be
difficult to treat..