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Are Antibiotics During Labor Effective at Preventing Group B Strep?

Group B strep is a bacterium normally present in the lower intestines and/or vagina in about 15-40% of women. The concern is that a woman delivering her child could expose the newborn to it, resulting in its contraction of early-onset GBS, a serious illness that can cause infections affecting the blood, lungs or brain, even death. Literature is showing that widespread use of antibiotics in labor for prevention is not effective.

Group B strep is a bacterium normally present in the lower intestines and/or vagina in about 15-40% of women. The concern is that a woman delivering her child could expose the newborn to it, resulting in its contraction of early-onset GBS, a serious illness that can cause infections affecting the blood, lungs or brain, even death. Literature is showing that widespread use of antibiotics in labor for prevention is not effective.

Infection in newborns  is quite rare: 1 in every 2,000 babies according to the American Academy of Obstetrics,  or .4 cases per 1,000 births in 2003-2006, according to the Center for Disease Control in 2009. Though it is rare, protocol exists to aggressively treat laboring women to prevent transmission because the results are considered so dire.

            Current policy advises that women between weeks 35 and 37 are tested for the presence of the bacteria, and those with a positive result are given antibiotics during labor, with the intent to kill the bacteria before the baby comes into contact with the birth canal. Also, all women delivering before 37 weeks are administered antibiotics automatically, as the GBS transmission rate has shown to be higher in births occurring early. This totals to about 30% of women receiving antibiotics during labor.

                WebMD notes  that half of all babies contracting Strep B died in the 1970s, and credits early recognition and aggressive treatment after diagnosis with the fact that fewer cases are fatal now. An interesting omission is the way aggressive administration of preventive antibiotics to women delivering has not decreased the number of infants contracting GBS, but has instead paralleled the rise of its incidence.

                Between one and two million women a year are given antibiotics in labor now, but early-onset GBS (within the first six days of life) in infants has been increasing since 2003, and late-onset GBS  (occurring between 7 days and three months of age) has also been increasing. Even GBS infection in women has increased 32% (as published in the Journal of the American Medical Association, 2009).

                Have the evolving abilities of bacteria, as known in the development of MRSA (methicillin-resistant Staphylococcus aureus), been forgotten?   One consequence of administering the preventive antibiotics to kill most of the GBS in the delivering mother also kills off healthy bacteria that keep the potentially harmful bacteria in check. If GBS is not completely eradicated (as typical in that some of the hardiest survive) the mother’s defenses against it were just wiped out.

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