On our page ‘What is GBS?’, we provide an extensive answer to this question. On it, we discuss the most important topics relating to this infectious disease, such as the symptoms, how GBS develops, the transmission from the infection to your baby, whether GBS can be cured, how prevention works, the history, research, and an explanation of the consultation card.

The symptoms experienced by an infected baby and mother depend on when the infection occurred. If labour is slow to start, changes in the unborn baby’s heart rate may indicate an infection with the GBS bacterium. Furthermore, a fever in the mother during labour can be a signal that the amniotic fluid – and, therefore, the unborn baby as well, is infected. The presence of meconium (a baby’s first bowel movement) can be an indication of an infection in the womb.

The symptoms immediately after birth are mainly abnormal breathing such as grunting on exhalation or rapid breathing. In addition, an infected baby often looks pale and is in poor general health. If the baby was already ill when born, it will usually have a lower Apgar score.

If the disease develops some time after the birth, grunting is usually the first symptom, an important warning sign that must always be taken seriously. Other signs that may indicate a GBS infection include rapid breathing, an unusual colour, poor feeding, a fever or, conversely, a low body temperature.

Group B Streptococcus do not cause the same illness in every baby. The most common diseases caused by the GBS bacterium are pneumonia, blood poisoning (sepsis) and meningitis. In rare cases, GBS can also cause skin infections (cellulitis), arthritis, inflammation of the heart valve (endocarditis) and inflammation of the eyeball (endophthalmitis). These conditions can also occur together.

Most babies recover completely. In the Netherlands, approximately 1 in 15 babies with GBS disease dies. After recovering from GBS, children are at greater risk of neurological developmental disorders such as behavioural problems, motor impairments and cognitive functioning disorders. They also often need extra support at school or attend special needs schools. For example, by the age of 10, 8% of children who have had GBS sepsis and 12% of children who have had GBS meningitis attend special needs schools. In comparison: 3% of comparable children who did not suffer from GBS disease attend special needs schools. The more severe the damage to the child, the sooner this becomes apparent. More subtle lingering effects sometimes only become apparent years later.

Short-term consequences:

• Blood poisoning (sepsis)
• Pneumonia
• Meningitis

Long-term consequences:

• Headache
• Deafness
• Vision problems
• Problems with gross and fine motor skills (mild symptoms of paralysis)
• Balance disorder
• Epilepsy
• Hydrocephalus
• Developmental delay
• Reduced muscle tension
• Spasticity

In the Netherlands, 1 in 5 pregnant women is (unaware that she is) a carrier of the bacterium. On average, half of the babies born to these GBS carriers become temporarily infected with the GBS bacterium. Most babies do not get ill from the infection, but approximately 1 in 100 children born to a mother who is a GBS carrier, do become severely ill during the first months of their life. Of this group, half of them become ill during the first week of life, and the other half in the first 3 months of their lives. A small number of children becomes ill with GBS again within a few weeks of successful treatment. GBS disease is very rare in children after the age of 3-4 months.

Guidelines on how to take action with GBS can be found in the Guidelines Database.

In the Netherlands, routine screening is not currently standard practice for all pregnant women. The question of whether this should be standard practice in weeks 35-36 of a pregnancy, has not yet been answered by scientists. Factors such as costs, potential unnecessary worrying and the danger of unnecessary administering of antibiotics play a big part in this.

Foundation OGBS believes that such a test should be offered at 35-36 weeks of pregnancy. If the pregnant woman is carrying the bacterium, she should be given antibiotics during labour. Experience in the United States shows that this approach has led to a significant reduction in the number of cases and deaths.

Not yet, although a lot of research is currently being done on a preventive GBS vaccine. This vaccine should be administered to the mother during pregnancy so that the baby is born with protective antibodies.

There are a number of risk factors that increase the chances of a GBS infection. These are:

• Prolonged rupture of membranes (longer than 18-24 hours)
• Premature birth (a pregnancy shorter than 37 weeks)
• Low birth weight
• A rise in the mother’s temperature during labour (above 38°C)
• A urinary tract infection caused by the GBS bacterium during the pregnancy
• A previous child who was affected by GBS disease
• A twin brother or sister with GBS disease

We recommend that you read up on the bacterium using reliable sources and review the guidelines issued by the NVOG (Dutch Society for Obstetrics and Gynaecology). Discuss the treatment plan with your gynaecologist. We can also imagine that you’d like to get in touch with others in a similar situation. To do so, please contact us via our contact form.

You are considered part of a risk group when you have previously had a baby who was infected with GBS and, therefore, preventative antibiotics will be administered during a next childbirth to protect your future baby. This treatment method is described in a guideline agreed upon nationally by gynaecologists and paediatricians.

Tell your GP and midwife or gynaecologist if one of your previous children became ill because of an infection by the GBS bacterium. Discuss the risk factors and work together to make a plan to minimise the risk of a new GBS infection.

The gynaecologist will assess your situation and only start treatment with antibiotics if absolutely necessary. In many cases, this is not done, as reinfection from the gut often occurs once the course of treatment has been stopped. Frequent use of antibiotics can also lead to allergic reactions, the development of resistance to those antibiotics in certain bacteria, and an imbalance in a woman’s normal gut flora. That is why it is important to take a critical look at the situation.

A urinary tract infection caused by GBS during pregnancy, is a risk factor during childbirth. The guidelines describe that antibiotics must be administered during childbirth.

Carrying the GBS bacterium causes a small portion of all premature births.

Premature (born too early) and dysmature (underweight) babies are more vulnerable to developing GBS than full-term babies, as their bodies and immune systems are not yet fully developed. They are also at a greater risk of developing lingering effects or passing away from GBS.

No, a baby can also be infected with GBS before or after birth.

GBS can be transferred to the baby through breastfeeding. Breast milk also contains substances that actually reduce the risk of GBS and other infectious diseases. The benefits of breastfeeding outweigh the risk of GBS infection, so you can continue to breastfeed your baby as normal.

No, anyone can carry GBS. It is therefore also possible for someone to carry the bacterium without having had sex before. The bacterium can, however, be transmitted through (oral) sex.