Prevention of Early-onset Neonatal Group B Streptococcal Disease

In 2017, the Royal College of Obstetricians and Gynaecologists (RCOG) published a guideline entitled, ‘Prevention of Early-onset Neonatal Group B Streptococcal Disease’.

The guideline recognises that Group B Streptococcal Disease, also known as Group B Strep (GBS), is the most frequent cause of severe early-onset infection in newborn infants. The purpose of this guideline is to provide guidance for obstetricians, midwives and neonatologists on the prevention of early onset (less than 7 days of age) neonatal Group B Streptococcal Disease and the information contained in the guideline can be passed on to women, their partners and families.

Early onset GBS infection usually presents in babies who are less than 7 days old as sepsis or pneumonia. The typical signs and symptoms are as follows:

Grunting, noisy breathing, moaning, the baby seems to be working had to breathe when looking at their chest or stomach, or not breathing at all

• Being very sleepy and/or unresponsive
• Inconsolable crying
• Being unusually floppy
• Not feeding well or not keeping milk down
• Having a high or low temperature, and/or the baby will be hot or cold to touch
• Having changes in their skin colour including (including blotchy skin)
• Having an abnormally fast or slow heart rate or breathing rate
• Having low blood pressure (identified by hospital tests)
• Having low blood sugar (identified by tests done in hospital)

This RCOG guideline on Group B Strep recommends that all pregnant women should be provided with an appropriate information leaflet.

Group B Strep Support (GBBS) have written a 12 page leaflet in partnership with the RCOG and this has and will undoubtedly continue to save lives. Sadly, not all pregnant women are provided with this leaflet nor information regarding GBS. We agree with both organisations that when these recommendations are fully implemented across the UK, the rate of avoidable GBS infection in newborn babies will fall.

The leaflet explains what GBS is and what this could mean for a baby. The leaflet also details the signs of early onset GBS as set out above and provides information about late-onset GBS infection. In addition, the leaflet provides advice and guidance on what testing for GBS and treatment options.

The leaflet also explains that if a parent for example notices any of the above signs or symptoms, or if they are worried about their baby, they should urgently contact their healthcare professional and also mention GBS. If a baby has GBS infection, early diagnosis and treatment is important as delay could be very serious or even fatal.

This informative and helpful leaflet entitled Group B Streptococcus (GBS) in pregnancy and newborn babies is available and free to download here.

The leaflet had been translated into 14 other languages in order to provide as many pregnant women as possible with information and advice regarding Group B Strep. These leaflets are available and free to download on the GBSS website.

The work that GBSS are doing to raise awareness of the signs and symptoms of Group B Strep; the need for more widespread screening; and the warning signs that medical staff should consider if there is a history of Group B strep is vital to ensuring the safety of newborn babies and will hopefully prevent further terribly sad cases of stillbirth and neonatal death.

If you or your baby has been affected by GBS infection and you believe that the care/treatment that you received from your medical professionals may have been substandard, please contact Laura Preston on ljpreston@slatergordon.co.uk. Laura is a medical negligence expert with a special interest in GBS cases and sits on the GBSS legal expert panel.