Introduction
Group B Streptococcus (GBS) is a bacterium that causes various dangerous infections, especially harmful to newborns. One such infection is Group B strep disorder, which is carried in the individuals’ genital tracts. Mothers usually transmit it to their babies during pregnancy, as bacteria come into contact with the baby’s skin. Adverse outcomes such as maternal and infant death and exposure to severe illnesses justify diagnosing and treating GBS early.
Group B Strep Infection and Pregnancy
Pathophysiology of the Disorder
The pathophysiology of GBS concerns all complex interactions between a mother and an infant. This infection differentiates between early-onset disease, covering the infant’s first week after birth, and late-onset disease developing later. Bacteria are transmitted vertically from the mother to the child during the child’s passage through the vaginal canal at delivery or in utero infection (Armistead et al., 2019). However, late-onset GBS disease is also possible through horizontal acquisition or transmission through human milk (Puopolo et al., 2019). These ways justify that infants are at risk of developing neonatal infections with fatal outcomes.
Risk Factors for Developing the Disorder
To diagnose the early development of Group B strep disorder, health professionals identify the main risk factors or physiological, biological, or other characteristics associated with a higher likelihood of exposure to bacteria. It is essential to note that GBS can be harmless for adults, but the danger appears during pregnancy and childbirth. Women with previous positive GBS tests are more likely to deal with similar GBS colonization throughout all subsequent pregnancies. Since females and their fetuses have lower levels of protective antibodies during lower gestational age, any fever might predict neonatal infection (Puopolo et al., 2019). It points to the fact that if a woman gives birth earlier in labor, she increases the risks of transmitting GBS infection to her infant.
Interestingly, GBS colonization differentiates between geographic regions, being more common in Southern and Eastern Asia, with 1 in 6 women hosts harboring bacteria compared to 1 in 3 females in the Caribbean (Armistead et al., 2019). Professionals are urged about the high occurrence in low and middle-income countries. Other surprising findings include African American race and women younger than 20 with high exposure to bacterial colonization due to limited access to healthcare and antibiotics (Puopolo et al., 2019). Meanwhile, women who use tobacco, have chronic hypertension, and pre-existing diabetes are more likely to have harmful GBS. Therefore, some host-specific factors can determine the degree of a person’s susceptibility to GBS invasion.
Effects of the Disorder on the Mother and Baby
The effects of GBS disorder on mother and child vary. The most frustrating finding about its influence on newborns is its 0.2% fatality rate in all cases (Raabe & Shane, 2019). Puopolo et al. (2019) justify it by stating that in 2015, 319000 invasive neonatal GBS cases caused 90000 deaths worldwide. However, high fatality risks are not the only harmful effects of GBS, since children also develop severe late-onset GBS diseases.
For example, meningitis, pneumonia, and bacteremia are the most common diseases among children. Additionally, Shabayek and Spellerberg (2018) emphasize that children who survive meningitis usually develop neurologic disorders, including seizures, cognitive impairment, hearing loss, and blindness in up to 50% of all cases (p. 2916). The child’s infection with GBS initiates this long chain of high morbidity risks.
For mothers, GBS disorder might also have severe outcomes. Pregnant women experience GBS twice as much as non-pregnant females (Raabe & Shane, 2019). The most frequent cases are when mothers deal with preterm labor. As an illustration, they have a 1.21 risk ratio of giving birth before the 37th week of gestation, bringing more complications to children and cesarean delivery to mothers than women without GBS (Raabe & Shane, 2019).
Maternal colonization by GBS is linked to maternal sepsis, a condition with extensive inflammation leading to organ failures and death (Edwards et al., 2019). Other adverse effects include maternal mastitis, breast abscess, and pyelonephritis. This combination of health complications correlates with high rates of infection-related maternal morbidity.
Treatment of the Disorder
Treatments for GBS include a gentle and professional approach from the health professional. The most accepted treatment is intrapartum antibiotic prophylaxis (IAP) – an intravenous antibiotic prescribed during the early GBS symptoms (Armistead et al., 2019). The American Academy of Pediatrics suggests using IAP before screening all pregnant women at 35-37 gestational weeks, highlighting its effectiveness in decreasing incidence (Shabayek & Spellerberg, 2018).
Outcomes for the Mother and Baby: Treated vs. Untreated
Therefore, if GBS is treated, a mother does not develop sepsis, urinary tract infections, or fever, contributing to her postpartum recovery. The same outcomes apply to a child as the treatment reduces the risks of pneumonia and many other early-onset diseases, improving the child’s immunity. In other cases, mothers suffer from sepsis when GBS is untreated, while their children face the risk of death. Such outcomes justify treating GBS as early as possible and avoiding its adverse impacts.
Conclusion
To conclude, Group B strep is a severe infection caused by bacterial colonization of women’s genital tracts. It is transmitted to her child in utero early, meaning that the fetus’s weak immune system fights against bacteria and develops meningitis, but more frequently, infants die from high exposure to the GBS invasion. To terminate these risks and avoid increasing morbidity and disease rates in women, they should take antibiotics.
References
Armistead, B., Oler, E., Waldorf, K. A., & Rajagopal, L. (2019). The double life of group B Streptococcus: asymptomatic colonizer and potent pathogen. Journal of molecular biology, 431(16), 2914-2931. Web.
Edwards, J. M., Watson, N., Focht, C., Wynn, C., Todd, C. A., Walter, E. B., Heine, R. P., & Swamy, G. K. (2019). Group B Streptococcus (GBS) colonization and disease among pregnant women: a historical cohort study. Infectious Diseases in Obstetrics and Gynecology, 1(2), 1-7. Web.
Puopolo, K. M., Lynfield, R., Cummings, J. J., Hand, I., Adams-Chapman, I., & Poindexter, B. (2019). Management of infants at risk for group B streptococcal disease. Pediatrics, 144(2), 1-17. Web.
Raabe, V. N., & Shane, A. L. (2019). Group B streptococcus (Streptococcus agalactiae). Microbiology spectrum, 7(2), 7-2. Web.
Shabayek, S., & Spellerberg, B. (2018). Group B streptococcal colonization, molecular characteristics, and epidemiology. Frontiers in microbiology, 9(1), 1-14. Web.