PeanutBean
Mumma to B & I
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This is a thread for those ladies who have been told they are carriers of Group B Strep. Having talked with some other ladies we thought it would be a good idea to have a common place to post links, advice, guidelines etc to help us get the homebirths we want went faced with negativity from the medical profession (and others) in light of our new special status shared by only a third of the whole population. 
I've only just started looking into this but what I'll do it update this post with the most useful and up to date information as and when we find it. So here are some links that I have found useful so far:
This site has a wealth of information and links and I believe reads in a fairly balanced way, not denying the risks of infection in newborns but realistically assessing the liklihood and the pros and cons and evidence surrounding common treatment protocol.
https://www.homebirth.org.uk/gbs.htm
This is the FAQ page of Group B Strep Support. This site has current guidelines and recommendations for the UK and as I was given a leaflet from the group by my MW I assume is accepted by the NHS too.
https://www.gbss.org.uk/content.php?sub_id=15§ion_id=3#q20
If I was to pick a single article that I found extremely helpful at present it would be this:
https://www.aims.org.uk/Journal/Vol15No4/WarOnGroupBStrep.htm
This is the summary of guidelines by the Royal College of Obstetricians and Gynaecologists, there is a link to the complete recomendations.
https://www.rcog.org.uk/womens-heal...neonatal-group-b-streptococcal-disease-green-
This is from KandyKinz who found this review of the ancient and sparse data used as the basis for Iv antibiotic administrtion:
Thought I'd add some basic statistics here:
*Number of live births in 2009 in the UK = 790,200
*Given 25% of women carry GBS in their vaginas that means 197,550 live births to GBS carriers
*At a 1 in 1000 rate of GBS infection there will have been approx 790 cases of GBS infection in babies (less in reality as the rate is slightly less than 1/1000)
*A mortality of 10% means 79 deaths from GBS (out of 790,200 births)
*80% of GBS cases are early onset, therefore 20% are not caused by maternal GBS, so that's 632 cases that can arguably be linked to maternal GBS.
*Obviously it's not possible to say how many deaths are linked to early onset/maternal GBS, but about 80% of deaths are linked to prematurity (before 37 weeks) so that's about 16 deaths in 2009 in term babies. Give or take. Out of 790,200 births. That wouldn't even be significant...
9/4/11
I'm at a loose end and have access to the literature so here are some of my findings from the most recent research I can access (note I can't be bothered to put the very full references and most people won't have access to the papers anyway):
Neonatal infections in England: the NeonIN surveillance network, Vergnano et al 2011
A three year study of neonatal infection in England 2006-2008 findings:
GBS was the most frequent cause of early onset (<48hrs) neonatal infection (50%). Incidence averaged 1/2000 over the three years. GBS was responsible for 8% of late onset. 82% of ALL infections occurred in babies born before 37 weeks 71% of these were born before 32 weeks. Overall infection rate was 4.1/1000. The discussion makes reference to there having been no change in GBS incidence from a study in 2001, unlike research in the US and Australia which show a decrease. It attributes this to the lack of a rigorous screening/antibiotics programme in the UK. It notes that with reduction of GBS in the US there is a rise in ampicillin-resistant E.Coli infection.
So my own summary of the data:
*So if there are 1/2000 GBS cases, approx 80% of these are in
7 week neonates which means the risk for GBS infection in term babies is 1/10,000. Approx 70% of those that are premature that are infected are
2 weeks so that puts the risk for them as approx 3/10,000. So a baby 32-37 weeks has a risk of about 1/10,000 also, bearing in mind I'm rounding up.. I'm struggling a bit with percentages of fractions but I think this is right!!
*It seems to me that those babies that suffer an early infection are probably predisposed for whatever unknown reason and that treating infection such as GBS en masse means that those vulnerable babies instead get an infection from a more antibiotic-resistant bacterium.
*It should be noted that maternal GBS status was not researched so these are the general risks for unknown status of carriership (is that a word?!).
Another study showed that preterm infants didn't have the same level of immune response as term infants which could be an explanation for the particular risk to premature babies.
Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine, Pereira et al, 2011
This showed that 2 vaginal washes of 1% chlorhexidine during labour (something mentioned in the above homebirth.org links) is 86% effective in clearing all cultures - this presumably means getting rid of the entire vaginal flora during childbirth - 4% of mums had vaginal burning but that seems to have been the only side effect. In 8 of 508 babies a wiping reduced their axillary temp by 1 degree, 2 had a rash from it.
Group B streptococci colonization in pregnant women: risk factors and evaluation of the vaginal flora, Rocchetti et al, 2011
This study concludes: The prevalence of GBS is high in pregnant women and is associated with sexual intercourse frequency, previous spontaneous abortion and the presence of candidosis or cytolytic vaginosis. There is another article I saw a while back that linked sexual activity with positive swabs too. so maybe abstain if you're worried or have a test coming up!
This post contains a regimen for natural removal of gbs culture that might be of interest: https://www.babyandbump.com/home-na...up-b-strep-support-thread-9.html#post11849819

I've only just started looking into this but what I'll do it update this post with the most useful and up to date information as and when we find it. So here are some links that I have found useful so far:
This site has a wealth of information and links and I believe reads in a fairly balanced way, not denying the risks of infection in newborns but realistically assessing the liklihood and the pros and cons and evidence surrounding common treatment protocol.
https://www.homebirth.org.uk/gbs.htm
This is the FAQ page of Group B Strep Support. This site has current guidelines and recommendations for the UK and as I was given a leaflet from the group by my MW I assume is accepted by the NHS too.
https://www.gbss.org.uk/content.php?sub_id=15§ion_id=3#q20
If I was to pick a single article that I found extremely helpful at present it would be this:
https://www.aims.org.uk/Journal/Vol15No4/WarOnGroupBStrep.htm
This is the summary of guidelines by the Royal College of Obstetricians and Gynaecologists, there is a link to the complete recomendations.
https://www.rcog.org.uk/womens-heal...neonatal-group-b-streptococcal-disease-green-
This is from KandyKinz who found this review of the ancient and sparse data used as the basis for Iv antibiotic administrtion:
The review gives very short shrift to the methodology of these very old studies. Well worth a read.PeanutBean - I found a Cochrane study you may find of interest.
https://onlinelibrary.wiley.com/o/coc...467/frame.html
https://www2.cochrane.org/reviews/en/ab007467.html (summary of the above)
Apparently while the antibiotics has been shown to decrease the risk of GBS infections it has had no impact on mortality rates or long term morbidities. When the potential risks of wide spread utilization of GBS prophylaxis is considered the end conclusion is that giving IV antibiotics to all colonized women in labour is not supported by conclusive evidence.
Thought I'd add some basic statistics here:
*Number of live births in 2009 in the UK = 790,200
*Given 25% of women carry GBS in their vaginas that means 197,550 live births to GBS carriers
*At a 1 in 1000 rate of GBS infection there will have been approx 790 cases of GBS infection in babies (less in reality as the rate is slightly less than 1/1000)
*A mortality of 10% means 79 deaths from GBS (out of 790,200 births)
*80% of GBS cases are early onset, therefore 20% are not caused by maternal GBS, so that's 632 cases that can arguably be linked to maternal GBS.
*Obviously it's not possible to say how many deaths are linked to early onset/maternal GBS, but about 80% of deaths are linked to prematurity (before 37 weeks) so that's about 16 deaths in 2009 in term babies. Give or take. Out of 790,200 births. That wouldn't even be significant...
9/4/11
I'm at a loose end and have access to the literature so here are some of my findings from the most recent research I can access (note I can't be bothered to put the very full references and most people won't have access to the papers anyway):
Neonatal infections in England: the NeonIN surveillance network, Vergnano et al 2011
A three year study of neonatal infection in England 2006-2008 findings:
GBS was the most frequent cause of early onset (<48hrs) neonatal infection (50%). Incidence averaged 1/2000 over the three years. GBS was responsible for 8% of late onset. 82% of ALL infections occurred in babies born before 37 weeks 71% of these were born before 32 weeks. Overall infection rate was 4.1/1000. The discussion makes reference to there having been no change in GBS incidence from a study in 2001, unlike research in the US and Australia which show a decrease. It attributes this to the lack of a rigorous screening/antibiotics programme in the UK. It notes that with reduction of GBS in the US there is a rise in ampicillin-resistant E.Coli infection.
So my own summary of the data:
*So if there are 1/2000 GBS cases, approx 80% of these are in


*It seems to me that those babies that suffer an early infection are probably predisposed for whatever unknown reason and that treating infection such as GBS en masse means that those vulnerable babies instead get an infection from a more antibiotic-resistant bacterium.
*It should be noted that maternal GBS status was not researched so these are the general risks for unknown status of carriership (is that a word?!).
Another study showed that preterm infants didn't have the same level of immune response as term infants which could be an explanation for the particular risk to premature babies.
Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine, Pereira et al, 2011
This showed that 2 vaginal washes of 1% chlorhexidine during labour (something mentioned in the above homebirth.org links) is 86% effective in clearing all cultures - this presumably means getting rid of the entire vaginal flora during childbirth - 4% of mums had vaginal burning but that seems to have been the only side effect. In 8 of 508 babies a wiping reduced their axillary temp by 1 degree, 2 had a rash from it.
Group B streptococci colonization in pregnant women: risk factors and evaluation of the vaginal flora, Rocchetti et al, 2011
This study concludes: The prevalence of GBS is high in pregnant women and is associated with sexual intercourse frequency, previous spontaneous abortion and the presence of candidosis or cytolytic vaginosis. There is another article I saw a while back that linked sexual activity with positive swabs too. so maybe abstain if you're worried or have a test coming up!
This post contains a regimen for natural removal of gbs culture that might be of interest: https://www.babyandbump.com/home-na...up-b-strep-support-thread-9.html#post11849819