Group B Strep Support – Why guess, why not test?
The research, conducted among 2,102 pregnant women on Bounty’s ‘Word of Mum’ Research Panel, showed that 41% of women had not heard of group B Strep.
Of those who had heard of group B Strep
- 33% of women had heard about it from a midwife, GP practice or antenatal class
- 67% had heard of it from other sources, almost half of these from a pregnancy book or magazine
44% of women who had heard of group B Strep had found all the information they needed, more than half had either not found any or not found enough information.
Almost one newborn baby a day in England, Wales & Northern Ireland suffers group B Strep infection, the leading cause of sepsis and meningitis in newborn babies. One in ten of these sick babies will die and a further one in twenty of the survivors will suffer long-term physical or mental disabilities.
Carrying group B Strep during pregnancy, which approximately 25% of women do, is recognised as a key risk factor for group B Strep infection in newborn babies and yet, as these new data show, most women are not being told about group B Strep by their health professionals.
Group B Strep infection in babies is up to 90% preventable when antibiotics are given in labour to women found to carry group B Strep by sensitive testing at 35 to 37 weeks of pregnancy. This is standard practice in many developed countries, including Australia, Argentina, Belgium, Canada, Chile, Czech Republic, France, Germany, Hong Kong, Italy, Japan, Kenya, Lithuania, Oman, Poland, Spain, Slovenia, Switzerland and the USA.
Countries which routinely offer antenatal testing for group B Strep have seen 71-86% reductions in the incidence of these devastating infections in newborn babies, whilst in the UK the incidence rose in the decade to 2010 by 46% (0.28 per 1,000 live births in 2000, 0.41 per 1,000 live births in 2010). The UK used a risk-based prevention strategy, introduced in 2003, and sensitive tests for group B Strep carriage are not widely available within the NHS. The data suggest this strategy isn’t having the desired effect.
Jane Plumb MBE, chief executive of national charity Group B Strep Support,says, “These latest data confirm what we hear all the time – women want to be informed about group B Strep, offered a reliable test in pregnancy and, when group B Strep is found or other risk factors arise, offered preventative antibiotics in labour. And they simply can’t understand why this happens in other countries but not here. To think that in 2013 women aren’t even being told about what is recognised as the most common cause of severe infection in newborn babies is astounding.”
95% of the women interviewed said that they would take a test for group B Strep in pregnancy if offered without charge by the NHS. 60% would pay the £35 to do it privately.
Jane Plumb continued, “Just why health professionals aren’t telling pregnant women about group B Strep remains a mystery. If they’re concerned that it will worry them, this new data suggest otherwise – when asked whether knowing about GBS affected their enjoying their pregnancy, nearly 9 out of 10 said it would not. Women are clearly keen both to be told about GBS and offered testing.”
Emeritus Professor at Imperial College and consultant obstetrician at the Chelsea and Westminster Hospital in London, Philip Steer comments, “Unlike countries where screening has been introduced, the UK has not seen falls in the incidence of this highly preventable disease, instead the rise in the number of births means that 50% more babies are reported as being affected each year than a decade ago. This is particularly distressing when we know that most GBSS disease can be prevented if we offer women a simple test, which allows them to choose to have penicillin in labour if they are carriers.” (Professor Philip Steer is also a member of Group B Strep Support’s medical advisory panel).
National charity Group B Strep Support campaigns for greater awareness and better prevention of group B Strep infection in babies, specifically asking that:
- Information about GBS be routinely given to all women as part of their antenatal care
- Sensitive testing for GBS be made freely available within the NHS and offered to every pregnant woman whose baby is at low risk of developing GBS infection
- Antibiotics be offered intravenously in labour to all mums whose babies are known to be at higher risk of developing GBS infection
- Vaginal swabs from pregnant women always be tested using a method that offers good sensitivity for GBS detection
Case study: Tilly’s story
Tilly Collins, born 17th March 2013 at 38 weeks. Suffered from EO (early-onset) GBS
Weight: 8lb 10oz : Location – Chandlers Ford, Hampshire
Mum Joanne’s pregnancy with Tilly was neither difficult, nor easy.
However, Joanne’s waters had gone more than 18 hours before Tilly was born (prolonged rupture of the membranes – more than 18 hours before delivery is recognised as one of the clinical risk factors where the risk of GBS infection is increased three-fold). Joanne had a normal vaginal delivery in a mid-wife led hospital and no antibiotics for group B Strep were administered.
Tilly very quickly developed breathing difficulties, continuous grunting and refused to feed. This continued for several hours. “We alerted this to the attention of the midwife on multiple occasions and after checks had suggested no obvious issues we were escorted to the special care baby unit where more tests were carried out,” says Joanne.
The doctor initially diagnosed a small tear in Tilly’s lung and she was placed in an incubator on a small dose of antibiotics. Twenty-four hours passed with little improvement, resulting in blood tests to identify any bacteria growth. Early results suggested a potentially serious bacterial infection which was shortly confirmed to be group B Strep meningitis and sepsis. This resulted in Tilly being cared for in Winchester’s SCBU for two weeks and receiving a course of antibiotics.
“We feel that this terrible ordeal could have been avoided if only the test for GBS was offered, especially knowing that this only costs £30 (privately) which seems a small price to pay considering the potential life changing impact of the infection. Also that cost compared to the cost of a two-week stay in SCBU seems fairly insignificant but despite that the care we received in SCBU was priceless. All the doctors and nurses we came across by far exceeded our expectations,” says Joanne.
Joanne feels very strongly that every pregnant woman should be made aware of this infection as this is currently not being undertaken as part of a pregnant woman’s antenatal programme. “Since having Tilly, I have found out a lot of information about group B Strep and I am upset we were not given any during my pregnancy.”
Since those traumatic two weeks where Tilly’s life was on the line, the Collins’s have been on an emotional journey, taking every day as it comes with the worry of what the long-term impact of the infection may be on Tilly. Six months into Tilly’s life, she is showing incredible strength and has fought every battle to date and is developing into a beautiful little girl.
For further information:
Jane Plumb, Chief Executive, Group B Strep Support for comment or greater detail
Tel: 01444 416176
For press Information:
Sarah Fiedosiuk, Media and Awareness, Group B Strep Support
Group B Strep Support, P O Box 203, Haywards Heath, West Sussex RH16 1GFwww.gbss.org.uk.
Registered Charity No 1112065. Company Registration No 5587535
Notes to editors:
GBS carriage: Group B Strep is a normal bacterium carried by up to 30% of adults in the intestines and approximately 25% of women in the vagina. It can be passed from mother to baby around labour. This causes no problems for most babies: for some, it can be deadly, causing blood infection, pneumonia and meningitis.
GBS infection in newborn babies: Group B Strep is the UK’s most common cause of life threatening infection in newborn babies. In England, Wales, the reported number of early-onset GBS infections has increased from 0.28 to 0.41 live births between 2000 and 2010. http://cid.oxfordjournals.org/content/early/2013/07/10/cid.cit337.abstract
A report on preventable death and disability caused by group B Strep calls for routine screening as incidence continues to rise in newborn babies in the UK is available athttp://www.gbss.org.uk/2013Report.
Risk factors GBS infection in babies: Newborn babies are at higher risk of developing group B Strep infection when certain ‘risk factors’ are present during the pregnancy, labour and delivery. These are: Mum carrying group B Strep during the current pregnancy, Mum having a urinary tract infection caused by group B Strep during the current pregnancy, a previous sibling having developed group B Strep infection, Mum’s waters breaking more than 18 hours before delivery, labour starting or waters breaking before 37 completed weeks of pregnancy and Mum having a fever in labour. However, these risk factors are only known to be present in fewer than 60% of newborn babies who develop group B Strep infection: determining whether a pregnant woman carries group B Strep late in pregnancy is a better indicator of the baby’s risk.
GBS testing: A few NHS trusts make sensitive testing for group B Strep available to pregnant women at the request of their health professionals, but most don’t. A number of private medical laboratories offer at-home-testing packs for around £35. Seehttp://www.gbss.org.uk/test for the availability of sensitive testing following Public Health England’s B 58 from NHS trusts and private laboratories. It has been estimated that the providing the test on the NHS would cost around £11.83 each. Group B Strep Support has no links and receives no money from any laboratory.
Group B Strep Support: Group B Strep Support provides information and support to families and health professionals affected by group B Strep. It is the UK’s only charity dedicated to the prevention of group B Strep infection in newborn babies and provides comprehensive and reliable information, both printed and online. Group B Strep Support is supported by an independent medical advisory panel http://tinyurl.com/GBSS-MAP
Streptococcal and Escherichia coli neonatal sepsis in Australasia. Pediatr Infect Dis J 2004; 23(7):630–634.