Group B Strep in Pregnancy
The short answer
Group B Streptococcus (GBS) is a common bacterium found in about 25% of healthy women. Being GBS-positive is not an infection or STI - it simply means the bacteria are present in your body. With standard intravenous antibiotics given during labor, the risk of transmitting GBS to your baby drops from about 1 in 200 to about 1 in 4,000, making outcomes excellent.
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By Age
What to expect by age
First trimester
GBS screening is not typically done in the first trimester because colonization status can change throughout pregnancy. If you had a previous baby affected by GBS disease, your provider should be aware early so they can plan prophylactic antibiotics during labor regardless of your screening result later.
Second trimester
GBS screening is not routinely performed in the second trimester either. However, if GBS is found incidentally in a urine culture at any point during pregnancy (GBS bacteriuria), you will automatically receive antibiotics during labor. GBS in urine indicates heavy colonization and does not need to be re-screened later.
Third trimester
Universal GBS screening is recommended between 36-37 weeks of pregnancy through a simple vaginal and rectal swab. Results are available within a few days. If you test positive, you will receive IV penicillin or an alternative antibiotic during labor, ideally at least 4 hours before delivery. This is the standard of care and is highly effective at preventing early-onset GBS disease in newborns.
Postpartum
If you received appropriate antibiotics during labor, your baby will be observed for the standard period after birth. If antibiotics were not given or given less than 4 hours before delivery, your baby may be monitored more closely for 24-48 hours for signs of infection such as fever, poor feeding, irritability, or breathing difficulties. Early-onset GBS disease in newborns is treatable with antibiotics.
What Should You Do?
When to take action
- You tested GBS-positive at 36-37 weeks - this is a common finding in healthy women
- You received antibiotics during labor and your baby shows no signs of infection after delivery
- You tested GBS-negative and your provider confirms no prophylaxis is needed
- You had GBS in a previous pregnancy but tested negative this time (colonization can vary between pregnancies)
- You tested GBS-positive and are unsure about your labor antibiotic plan, especially if you have a penicillin allergy
- Your labor is progressing very quickly and you are concerned about receiving antibiotics in time
- You had a previous baby with GBS disease or a previous positive GBS urine culture
- Your newborn develops fever, poor feeding, extreme sleepiness, difficulty breathing, or irritability in the first week of life
- Your water breaks before 37 weeks and you know you are GBS-positive or your status is unknown
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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