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Expert Q&A:
What is Group B streptococcus, and how do you catch it?

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Margaret Freda
Answered by Margaret Freda Ed.D., R.N., C.H.E.S., F.A.A.N.
"I've been a professional nurse working with pregnant women and parenting families since 1966," says Margaret Comerford Freda. "Pregnant women and parents need to know as much as possible about their own health and that of their children."

Margaret Comerford Freda, Ed.D., R.N., C.H.E.S., F.A.A.N., is a Professor in the Department of Obstetrics &; Gynecology and Women's Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, and also serves as Director of Patient Education Programs for that department. Since 1993, Dr. Freda has been the Consultant for Nursing at the National March of Dimes Birth Defects Foundation and the Chair of the National March of Dimes Nurse Advisory Council. In addition, Dr. Freda serves as the editor of MCN, The American Journal of Maternal Child Nursing.

Dr. Freda received her Master's Degree in Nursing from New York University and her doctorate in Health Education from Columbia University. She has worked in women's health for her entire professional career. Dr. Freda has published 50 research articles in professional journals, and is a frequently invited speaker at nursing and medical conferences. She has written two books: Perinatal Patient Education, published by Lippincott Williams &; Wilkins, and Miscarriage After Infertility, published by Fairview Press, written with her daughter Carrie Semelsberger, who is also a nurse.

Dr. Freda has received several noteworthy awards, such as the Distinguished Professional Service Award and the First National Award for Excellence in Nursing Research from the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN), the Woman of Distinction Award and the Maternal Child Nurse of the Year Award from the March of Dimes, the Patient Care Award for Excellence in Patient Education from the American Academy of Family Physicians, the Research Recognition Award from Molloy College, and several Outstanding Research Paper awards at national conferences. She serves on the Scientific Advisory Council for the March of Dimes, and was selected to serve on the Select Panel of the Centers for Disease Control to advise on prenatal health. Dr. Freda has developed patient education booklets and videotapes that are now distributed nationally.

Dr. Freda has been married for four decades. She has two daughters, two sons-in-law, three grandsons, and a granddaughter.
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Question


What exactly is Group B streptococcus? How do you catch it? I tested negative for it in my first pregnancy, but positive in my second. Every book I have read says that 30 percent of women carry it and have always had it. My pregnancies were eight months apart -- how could I have gotten it in such a short time? And from where?

Answer


This is a complicated question to answer in a short space, but I'll try to be succinct. It's true that many pregnant women harbor these bacteria in their lower genital tract or rectum; infections such as this are actually more common in pregnancy. A problem arises if the pregnant woman develops a major infection in the uterus during her pregnancy (in which case she would develop a fever and be quite sick) or if she passes the bacteria to the baby during the birth itself. Group B streptococcus (GBS) in a newborn can have devastating results. You were tested and found positive. You were probably treated with antibiotics as well. Although this would seem to be the best thing for protecting a fetus, unfortunately it does not always work. Many women who are treated while pregnant become "re-colonized" later. The American Academy of Pediatrics (AAP) recommends that all pregnant women should be screened for GBS, and colonized women should be treated with intravenous (IV) antibiotics at the time of labor so there is no chance that the baby will contract the disease while it is being born. The American College of Obstetricians and Gynecologists (ACOG) suggests that only women who have risk factors be screened in pregnancy, but agrees with the AAP that women who test positive should be treated during labor. How did you get it? It's anyone's guess. GBS is a common infection. The important thing is that you know that you have tested positive, and that you get treatment by IV when you are in labor. Be sure that whoever is taking care of you in labor knows all about this.

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