February 2011 is International Prenatal Infection Prevention Month and, although many western countries offer pregnant women testing for the most common cause of life-threatening infection in newborn babies, we don't in the UK.
Other countries have seen their incidence of group B Streptococcal (GBS) infection in newborn babies fall dramatically – in the US by 80% - while the incidence in the UK increased by 16% between 2003 and 2009.
Group B Streptococcus (GBS or group B Strep) is a bacterium that is carried by 1 in 4 pregnant women – it's usually harmless. It can be passed from the mother to her baby around birth and, without preventative medicine, an estimated one out of every 300 babies born to women carrying GBS would become seriously ill – approximately 700 sick babies a year, of whom 75 babies would die and another 40 would suffer serious ongoing health issues.
Since 2003, the advice from the Royal College of Obstetricians & Gynaecologists has been to give antibiotics in labour to 'higher risk women' including those who have previously had a baby with GBS infection, who develop a GBS urinary infection during pregnancy, or who have symptoms such as fever during labour – yet fewer than 60% of the mothers of babies who develop GBS infection have these risk factors and so this strategy can prevent fewer than 60% of these infections.
The most common risk factor for a baby developing GBS infection is the mother carrying GBS when the baby is born. Without testing pregnant women, most mothers whose babies are 'higher risk' will not be identified, so antibiotics in labour will not be offered and most infections won't be prevented.
Recent research suggests that the NHS could make significant cost savings by introducing sensitive testing for all pregnant women at 35-37 weeks and offering antibiotics in labour accordingly. The authors found that 'The current strategy of risk-factor-based screening is not cost-effective compared with screening based on culture.'
They calculated that the Royal College of Obstetricians & Gynaecologists' risk factor approach costs £50,000 per infection prevented, whereas routine screening would cost £45,000 (screening is more efficient because it prevents more cases). This is a purely financial advantage, not accounting for the savings from fewer babies needing long-term medical care, nor considering the distress to parents who lose their baby from preventable GBS infection.
Group B Strep Support, which has been campaigning for enriched culture testing for approaching ten years, welcomed the recent research by Kaambwa et al. Chief Executive Jane Plumb, who lost her middle child to GBS infection, says, 'It's been obvious for some time that the Royal College of Obstetricians & Gynaecologists' risk-based guidelines are less effective than routine testing in the number of babies' infections, deaths and disabilities prevented. There is now more good evidence that using the current strategy costs the NHS more than routine testing. It is surely time for the Government to start thinking with its head as well as its heart and offer pregnant women routine testing.'
February 2011 has been designated International Prenatal Infection Prevention Month – during the month, Group B Strep Support will be sending information to maternity units to help them inform more pregnant women about group B Strep so they can decide whether they want to be tested or not.
Volunteers will be contacting their MP to ask for their support for sensitive group B Strep tests to be made available via the NHS to all pregnant women.
Your comments (terms and conditions apply):
"Yes it should be tested for routinely. My first child would still be here if it was" - Sarah Ilott, Bedfordshire
"There is no doubt in my mind that it should be offered routinely. My midwife never told me about group b strep and at the time of my pregnancy there was nothing about it in the pregnancy magazines. My daughter contracted a late onset infection at 17 days old. The meningitis and septicaemia has left her with brain damage. Her development is delayed and
she has a learning difficulty. The cost of her ongoing care in health and social care will far outweigh the cost of a test. At least tell pregnant mums about it, give them the info so that they can make an informed decision as to whether they want the test done privately. I am lucky to have my beautiful 6 year old still with me, others weren't so lucky. I urge the NHS to give pregnant women free, reliable tests. You WILL save
lives and in the long term save money. Don't put anymore families through what we've had to (and still are) go through" - Sheryl Carty, Milton Keynes
"Definitely. It should be part of the routine screening already done in pregnancy" - Naomi, Crawley
"If it prevents babies becoming seriously ill then there should be no question about it being offered routinely!!" - Debi Patterson, Devon
"Yes" - Elizabeth Swallow, Kent
"Yes, it should be offered routinely, using sensitive tests" - Jane Plumb, Haywards Heath
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