Proof that testing mothers for killer bug saves babies
ALEADING hospital has slashed cases of a deadly infection that can kill newborn babies – by defying national guidelines to offer all pregnant women a simple screening test.
Government officials have repeatedly insisted there is no evidence to support universal screening for Group B Strep, known as GBS, even though it is carried by one in four women and kills as many as 400 newborns in the UK every year.
Current guidelines only recommend testing women deemed to be ‘at risk’.
But a programme which offered screening to all expectant women at Northwick Park NHS hospital in North-West London resulted in not a single case of the bacteria spreading to infants among those who were tested and subsequently treated with antibiotics. The only recorded cases during the 12-month programme affected babies of women who had not agreed to be tested.
Crucially, clinicians noted that half of the women who tested positive for GBS would not have been classified as ‘at risk’ under the cur- rent guidelines – so their babies would not have been protected.
The UK National Screening Committee carried out a review in 2012 in collaboration with the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives and NHS England. It concluded that not all women who test positive for GBS will go on to develop the infection or pass it on to their babies, so blanket screening would mean pregnant women would be unnecessarily given antibiotics, which carry their own risks to the foetus.
Some studies link antibiotics used in pregnancy and labour to obesity and asthma. In premature babies an increased risk of cerebral palsy has been associated with use of some antibiotics in labour.
Yet these results confound the decision, prompting calls for the Government to introduce universal testing for pregnant women during standard ante-natal appointments, as is the case in Germany, France and the US.
Jane Plumb, chief executive of the charity Group B Strep Support, said: ‘The risk-based strategy has failed to reduce the rate of GBS infection, and these findings contradict the party line that the risks of screening every woman would outweigh the benefits.’
The consultant microbiologist who introduced the screening programme at Northwick Park, Dr Guduru Gopal Rao, said: ‘There was a substantial burden of infection in our local community which was not being prevented by the national guidelines.
‘Our work shows that GBS screening of all expectant mothers can work and is likely to be more effective than the current risk based approach.’
Dr Richard Nicholl, consultant neonatal paediatrician at London North West Healthcare NHS Trust, said he had seen more than 100 babies with GBS in 20 years. He said: ‘It can lead to serious illness and high mortality rates so it is much better to prevent the infection, rather than attempt to treat it.
‘Since we began our comprehensive screening programme, I have not seen a new case in the babies of the mothers we have screened.’
GBS is the most common cause of infection in newborn babies in the UK. Harmless when carried by women, it can prove fatal to babies who contract it when passing through the birth canal. Many develop meningitis and septicaemia and, if they survive, can be left with life-altering disabilities.
Known as the enhanced culture method, the test simply involves taking a swab from the woman. It would cost the NHS approximately £11 per patient.
Belinda Bowman, 37, lost her daughter Lily after she contracted GBS during labour and developed meningitis and septicaemia. She was just three days old.
Belinda, who has three older children, had asked a midwife for a GBS test when she went to be induced at St Peter’s Hospital, Chertsey, in May 2013 after noticing some unusual discharge.
But she was told it was ‘not standard practice’ and there was ‘no reason’ to give her test.
Mrs Bowman said: ‘What hurts most is that Lily’s death was entirely preventable.’
Mrs Bowman is now involved in a legal battle with the hospital over claims that staff repeatedly failed to spot how seriously ill Lily was after her birth.
She is being represented by law firm Leigh Day.