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Prevention of Early-onset Group B Streptococcal Disease (Green-top Guideline No. 36)


GBS is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. There is variation in practice across the UK regarding the best strategies to prevent EOGBS disease. 

In 2015, the incidence of EOGBS in the UK and Ireland was 0.57/1000 births (517 cases), a significant increase from the previous surveillance undertaken in 2000 where an incidence of 0.48/1000 was recorded.

The purpose of this guideline is to provide guidance for obstetricians, midwives and neonatologists on the prevention of early-onset (less than 7 days of age) neonatal group B streptococcal (EOGBS) disease and the information to be provided to women, their partners and families. Prevention of late-onset group B streptococcal (GBS) disease and treatment of established GBS is not considered beyond initial antibiotic therapy.

COVID disclaimer

This guideline developed as part of the regular programme of Green-top Guidelines, as outlined in our document Developing a Green-top Guideline: Guidance for developers (PDF), and prior to the emergence of COVID-19.

Version history

This is the third edition of this guideline.

Please note that the RCOG Guidelines Committee regularly assesses the need to update the information provided in this publication. Further information on this review is available on request.

Developer declaration of interests

DR RG Hughes: Dr Hughes is a General Medical Council performance assessor and is the Chair of the NICE Intrapartum care for high-risk women guidelines committee.
Professor P Brocklehurst: Professor Brocklehurst has received a number of grants for his work in research. Professor Brocklehurst is the Chair of the MRC/NIHR Methodology Research Programme panel and the MRC/NIHR Women’s and Children’s Health panel, is a member of the NIHR/HTA Prioritisation panel and is a trustee of Wellbeing of Women.
Professor PJ Steer: Dr Steer has received travel and accommodation expenses to attend meetings and conferences, and has received honoria for delivering lectures. Dr Steer also receives book loyalties for “Heart Disease in Pregnancy” and “High Risk Pregnancy Management Options”. Since 1985, Dr Steer has acted as a mediolegal expert for obstetric clinical negligence cases. Dr Steer is Chair of the Medical Advisory Panel and GBSS. Dr Steer has shareholdings with Path2Safety Ltd. and Caretek Medical UK.
Professor P Heath: The university at which Professor Heath is employed has received grants from charities to undertake GBS-related work. Professor Heath has acted as a mediolegal expert for two perinatal infection clinical negligence cases since October 2013.
Professor BM Stenson: Professor Stenson received commercial funding for the CTIMP study and has received consultation fees from NICE. Professor Stenson receives royalties for “Macleod’s Clinical Examination” and received payment for his editorial work on an edition of “Archives of Disease in Childhood Fetal and Neonatal Edition”. Professor Stenson provides medicolegal reports and is a faculty member of “Reason”.

This page was last reviewed 13 September 2017.