Group B Streptococcus (GBS) is the most common cause of early-onset severe infection in the neonatal period. It is thought around 20-40% of mothers have GBS present in their bowel flora and may therefore be thought of as 'carriers' of GBS. Infants may be exposed to maternal GBS during labour and subsequently develop potentially serious infections.

Risk factors for Group B Streptococcus (GBS) infection:

• prematurity
• prolonged rupture of the membranes
• previous sibling GBS infection
• maternal pyrexia e.g. secondary to chorioamnionitis

Management

• universal screening for GBS should not be offered to all women
• the guidelines also state a maternal request is not an indication for screening

Intrapartum antibiotic prophylaxis:

• women who've had GBS detected in a previous pregnancy should be informed that their risk of maternal GBS carriage in this pregnancy is 50%. They should be offered intrapartum antibiotic prophylaxis (IAP) OR testing in late pregnancy and then antibiotics if still positive
• if women are to have swabs for GBS this should be offered at 35-37 weeks or 3-5 weeks prior to the anticipated delivery date
• IAP should be offered to women with a previous baby with early- or late-onset GBS disease
• IAP should be offered to women in preterm labour regardless of their GBS status
• women with a pyrexia during labour (>38ºC) should also be given IAP
• benzylpenicillin is the antibiotic of choice for GBS prophylaxis