group strep negative pregnancy positive

Group b strep negative first pregnancy positive second

The recurrence risk of group B Streptococcus in consecutive deliveries

Misgav Rottenstreich et al. J Matern Fetal Neonatal Med. 2020 Jul.

Abstract

Background: Group B streptococcus (GBS) is a significant cause of neonatal morbidity and mortality. GBS maternal colonization status was found to be transient, intermittent, or chronic and screening during each subsequent pregnancy was advised. Recent studies showed that GBS colonization rate was higher among women with history of GBS positive in prior pregnancy.Objective: To establish the cumulative risk of group B streptococcus (GBS) colonization in consecutive subsequent term deliveries as referred to the first delivery GBS colonization status.Study design: A retrospective cohort study, based on a validated computerized database at a tertiary single center between the years 2005-2016. Pregnant women preform vaginal-rectal culture at 35-37 weeks of gestation. We analyzed records of term primiparas women that had records of up to three additional term consecutive deliveries and GBS colonization status.Results: 8641 primiparas met inclusion criteria; 3972 (46.0%), 993 (11.5%), and 243 (2.8%) had second, third, and fourth consecutive deliveries with recorded GBS status respectively. The overall colonization rate for primiparas was 28.4%. The cumulative rates and cumulative risks of repeated GBS positive colonization at the second, third and fourth term consecutive deliveries were 62.0%, 6.93 (95% CI 5.96-8.06), 68.0%, 5.05 (95% CI, 3.67-6.93), and 66.1%, 2.96 (95% CI, 1.54-5.68), respectively. Notably, after a negative GBS colonization in the first, second, and third repeated deliveries, the rate and cumulative risk of GBS positive in each consecutive delivery was significantly lower: 18.2%, 0.14, (95% CI 0.12-0.17), 19.4%, 0.21 (95% CI 0.15-0.28), and 21%, 0.26 (95% CI 0.13-0.51) for the second, third, and fourth consecutive deliveries, respectively.Conclusion: GBS colonization status at the time of first pregnancy is a milestone for the colonization risk in subsequent term deliveries. This risk evaluation may influence the decision-making process for future screening and intrapartum antibiotic prophylaxis for term consecutive deliveries.

Keywords: GBS colonization; Streptococcus agalactiae; group B streptococcus; pregnancy.

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FAQ105
Published: July 2019
Last reviewed: July 2021

Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

Will I have group B strep with every pregnancy?

About 1 out of every 4 women have GBS. In pregnant women, GBS can cause infection of the urinary tract, placenta, womb, and amniotic fluid. Even if they haven't had any symptoms of infection, pregnant women can pass the infection to their babies during labor and delivery.

Can you get strep B second pregnancy?

If you've had GBS in a previous pregnancy This is because there is a 1 in 2 (50%) chance that you will be carrying it again in this pregnancy. You can have a swab test (known as the enriched culture medium or ECM test) to see whether you are carrying GBS when you are 35-37 weeks pregnant.

What does it mean if your Strep B test comes back positive?

A positive test indicates that you carry group B strep. It doesn't mean that you're ill or that your baby will be affected, but that you're at increased risk of passing the bacteria to your baby.

Will I have group B strep forever?

People who carry GBS often have no symptoms. GBS can come and go. Testing positive for GBS does not mean you will have it forever. But you will still be considered a carrier for the rest of your life.

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