The Test Expectant Moms Shouldn't Skip

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FRIDAY, July 11, 2003 (HealthDayNews) -- When women visit Dr. William Frumovitz late in their pregnancy, they're probably thinking about bassinettes, baby clothes and breast-feeding.

So the California obstetrician makes it a point to tell them about a very important test they need between their 35th and 37th week of pregnancy -- one that will tell them whether they have a bacterium called Group B streptococcus, which can threaten the life of their newborn.

Also known as GBS, or Group B strep, it is the most common cause of sepsis and meningitis in newborns, according to the U.S. Centers for Disease Control and Prevention (CDC). Just last year, the CDC revised its 1996 guidelines for GBS testing and now recommends universal screening of all pregnant women at 35 to 37 weeks of pregnancy. In addition, the National Institutes of Health has declared July as National Group B Strep Awareness Month.

Before the screening guidelines were strengthened, about 8,000 infants in the United States got Group B strep every year, and one of every 20 infected babies died. Those who survive often have long-term problems with hearing, vision and learning.

Problems related to Group B strep, which usually is found around the vagina and rectum, can occur a few hours after birth. Sepsis, meningitis and pneumonia are the most common, the CDC says. But diseases related to Group B strep can also crop up months after birth.

In the past, Frumovitz says, doctors had a choice: Screen at 35 to 37 weeks of pregnancy and decide on a course of action based on the result, or follow a "risk-based" method. That meant identifying women who would be likely to need intravenous antibiotics during labor -- the treatment to prevent transmission -- by their individual risks. These could include delivery before 37 weeks or a fever just before labor.

Like most doctors, Frumovitz has switched to routine screening. The test itself is relatively inexpensive, about $25. And the benefits of catching the bacterium early are immense, says Frumovitz, who is also an assistant visiting professor at University of California Los Angeles' David Geffen School of Medicine.

While not all women who have the bacterium will pass it on to their babies, if they do it can be a life-threatening problem, he says. And treating it is fairly simple.

Awareness about the dangers of Group B strep for newborns is growing, says Dr. Laura Riley, an assistant professor of obstetrics and gynecology at Harvard Medical School who chairs the committee on obstetric practice for the American College of Obstetricians and Gynecologists. The college also now recommends universal screening of all pregnant women.

While many women have known about the dangers of Group B strep, Riley says, some may not be aware that the guidelines for detecting it have changed.

"Until last year, doctors could culture at 35 to 37 weeks and treat those with a positive culture, or not culture anyone and during labor if risk factors arose those women would get antibiotics," she says.

"Now, we culture all pregnant women between 35 and 37 weeks," says Riley, a specialist in infectious diseases. All women should expect their doctor to give them this test. If they don't, women are encouraged to ask about it.

Riley also tells pregnant women to follow up with their doctor about test results. Don't assume you're fine, she says. Be sure to get the results. Then, if they're positive, you will be advised about getting antibiotics during labor.

"The antibiotics a mom gets during labor decreases the Group B strep in the vagina and the amount the baby comes into contact with," Riley explains.

While the prospect of Group B strep sounds scary, Riley add, it's also important to put it in perspective.

"Twenty to 40 percent of pregnant women will have a positive culture. Of those, a teeny percentage will go on to have a baby who is infected," she says.

More information

For more on Group B strep screening, visit the American College of Obstetricians and Gynecologists. For information on Group B strep and newborns, check out the U.S. Centers for Disease Control and Prevention.