Group B Strep Support welcomes the updated clinical guidance from The Royal College of Obstetricians & Gynaecologists on preventing group B Strep infection in newborn babies. When the recommendations are fully implemented across the UK, we will see the rate of avoidable group B Strep infection in newborn babies start to fall.
Key recommendations include:
- All pregnant women are provided with an information leaflet on group B Strep (new)
- Women who carried GBS in a previous pregnancy should be offered the option of GBS-specific (ECM) testing for GBS late in the current pregnancy (new)
- Women are offered intravenous antibiotics in labour where:
- Mum is in established preterm labour (before 37 weeks of pregnancy) (new)
- GBS has been detected during the current pregnancy
- GBS was detected in a previous pregnancy and the baby was healthy, and Mum has not had a negative ECM test in the current pregnancy (new)
- A previous baby developed GBS infection
- Mum has a fever in labour of 38 or higher
Three key new recommendations in particular will play a vital role in raising awareness and empowering women to make informed decisions about what is right for them and their babies:
- A leaflet, jointly written by experts from the RCOG and GBSS and recommended to be provided to all pregnant women – this is now available online from the RCOG and from GBSS, and will be available as a hard copy in 2018 from Group B Strep Support.
- Recommending that women who carried GBS in a previous pregnancy should be offered either routine antibiotics OR a GBS-specific test will mean that NHS trusts will make the GBS-specific ECM test available (click here for the UK Standard for testing specifically for GBS carriage).
- Recommending antibiotics to women in preterm labour will help protect preterm babies, who are more vulnerable to all kinds of things, including GBS infection, than their full-term counterparts and suffer disproportionately as a result.
There are other important new recommendations but the above will we think have the biggest impact on preventing avoidable GBS infection in newborn babies.
“We welcome this major update to The Royal College of Obstetricians & Gynaecologists’ (RCOG) clinical guidance which represents a significant improvement in the procedure to prevent Group B Strep infection in newborn babies. When this is fully implemented across the UK, we should at last see the rate of these usually preventable infections start to fall.
“The key new recommendations are for
- all women in established preterm labour to be offered intravenous antibiotics
- certain women are to be offered the ECM test for GBS carriage during pregnancy within the NHS and
- all pregnant women are to be provided with an information leaflet on GBS.
“These new recommendations will mean that more babies are protected from avoidable GBS infection in babies, which is great news for families and their babies.
“We at Group B Strep Support have been working closely with the RCOG to develop a joint patient information leaflet, which will significantly improve the quality and regularity of information on GBS. This increased access to clear, concise information will play a vital role in raising awareness of GBS and empowering women to make informed decisions throughout their pregnancy and in the early days after birth.”
Some will be disappointed that the RCOG’s 2017 guidelines don’t recommend universal testing for GBS carriage of all pregnant women.
While we believe universal testing would prevent more GBS infection, disability and death in newborn babies, it is the UK National Screening Committee’s responsibility to recommend for or against screening programmes, not the RCOG’s. Sadly, despite the evidence that developed countries (most of which use the screening approach to GBS prevention) have seen major reductions in their rates, and despite research reporting screening is both more cost- and clinically-effective than a risk-based approach, the UK NSC has rejected this evidence.
The UK NSC’s next planned review is currently scheduled for 2019/20, although this may be deferred by several years pending the results of research expected to start in 2019.