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Group B Streptococcus

The UK NSC policy on Group B Streptococcus screening in pregnancy

Policy Recommendation

Systematic population screening programme not recommended

 
Type Antenatal
Last review completed November 2012
Next review due in 2015/16
 

Screening for GBS should not be offered to all pregnant women. This is because there is insufficient evidence to demonstrate that the benefits to be gained from screening all pregnant women and treating those carrying the organism with intravenous antibiotics during labour would outweigh the harms.

The current UK rate of early onset GBS is comparable to that in countries in which screening is recommended. A significant burden of disease is found in risk groups whose management would not be affected by a screening programme. The ability of screening to significantly impact on mortality and long term morbidity caused by GBS is uncertain.

Systematic reviews of culture testing suggest that many screen positive women may no longer be carriers at the point of treatment. In the absence of a diagnostic test, current screening strategies are unable to distinguish between carriers whose babies will be affected by early onset GBS and those which would not. As a result many thousands of low risk women would receive intravenous antibiotic prophylaxis during labour. The consequences of expanding antibiotic usage in this way are unknown.

A number of Questions and Answers have been written to help explain the rationale (updated May 2014).

 
Key downloads Last external review - Review of Group B Streptococcus against UK NSC criteria July 2012
Last policy review summary
 

What is screening?

More about Group B Streptococcus

GBS is one of many bacteria that can be present in our bodies. It usually causes no harm. This situation is called carrying GBS or being colonised with GBS. GBS is commonly found in the digestive system and the female reproductive system. It's estimated that about one in four pregnant women in the UK carry GBS.

Around the time of labour and birth, many babies come into contact with GBS and are colonised by the bacteria. Most pregnant women who carry GBS bacteria have healthy babies. However, there's a small risk that GBS can pass to the baby during childbirth. Rarely, GBS infection in newborn babies can cause serious complications that can be life-threatening.

Extremely rarely, GBS infection during pregnancy can also cause miscarriage, early (premature) labour or stillbirth. If a baby develops GBS infection less than seven days after birth, it's known as early-onset GBS infection. Most babies who become infected develop symptoms within 12 hours of birth.

It's estimated that about one in 2,000 babies born in the UK and Ireland develops early-onset GBS infection. This means that every year in the UK (with 680,000 births a year) around 340 babies will develop early-onset GBS infection.

There are a number of clinical risk factors which increase the risk of EOGBS sepsis. These include preterm birth (less than 37 weeks gestation), prolonged rupture of the membranes and maternal fever in labour. In the UK healthcare professionals are encouraged to identify and manage high risk pregnancies on the basis of an assessment of these risk factors.

The Royal College of Obstetricians and Gynaecologists have published a guideline for professionals and information for the public.

» View the professional guideline

» View the public information

Policy stakeholders

Group B Strep Support
National Childbirth Trust
Royal College of Obstetricians and Gynaecologists
Royal College of Paediatrics and Child Health

The stakeholder groups will be involved when the policy is next reviewed. If you think your organisation should be added, please contact us. More about the policy review process, including the role of stakeholders, can be found in the guide to Engaging with the UK NSC's policy review process.

Related documents

icon GBS Consultation- Commercial Comments (PDF document, 988KB, 11/12/12)
icon GBS Consultation- Individual Professional's Comments (PDF document, 366KB, 11/12/12)
icon GBS Consultation- National Organisations' Comments (PDF document, 12.93MB, 11/12/12)
icon GBS Consultation- Public Comments (PDF document, 12.79MB, 11/12/12)
icon GBS FAQs May 2014 (PDF document, 66KB, 17/06/14)
icon GBS_COMMENTS_Politicians (PDF document, 203KB, 26/07/13)

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