Why won't Britain act to prevent biggest killer of newborns The 10 test that could save babies from death
00:33 GMT, 20 March 2012
When Sarah Campbell’s waters broke six weeks before her due date, she convinced herself that her baby son must be ready for the world.
And when, eight hours later, Ewan was delivered by emergency Caesarean apparently healthy and a good weight, Sarah and husband Adam, 45, a headteacher, felt reassured.
‘We were so happy, Adam and I couldn’t stop smiling,’ she says.
Joy after tragedy: Adam and Sarah Campbell with their healthy daughter Lorna. Their son Ewan died just eight hours after being born
Immediately after delivery, Ewan was briefly laid on his mother’s chest.
It was the only time Sarah held her baby — for just eight hours after his birth, Ewan died.
Unknown to his parents or doctors, he had picked up the potentially fatal group B streptococcus infection from his mother.
‘The doctors said they needed to take him to the special care baby unit only because he’d been born early,’ says Sarah, 34, a teacher from Kempston, Bedfordshire.
‘They said if he fed OK, I’d be able to have him on the ward with me the following morning.’
Four hours after their son’s birth, Adam headed home at 3am to get some rest. He never had the chance to hold his son.
‘We thought we had all the time in the world for cuddles,’ says Sarah.
Shortly afterwards, a nurse told Sarah that Ewan was having problems breathing.
She said it was to be expected because of his prematurity, but returned minutes later with some laminated photographs of him.
Sarah was still clutching the photographs a couple of hours later when a doctor came to tell her Ewan wasn’t ‘doing very well’ and the paediatric consultant had been called.
Group B streptococcus is the biggest killer of newborn babies in Britain, yet we are one of the few developed countries not to screen for the infection
‘I was desperate to see my son but, because of the Caesarean, I couldn’t stand or even sit in a wheelchair, so they wheeled my hospital bed to the special care baby unit.
‘There was a team working on Ewan and someone said: “I don’t think it’s a good idea for her to be here right now.” I was wheeled back to the ward.’
Just before 7am, Sarah was bundled into a wheelchair and rushed down to special care.
‘Ewan was being hand-ventilated and was wired up to different monitors.
'The paediatric consultant uttered the words no parent wants to hear: “There’s nothing more we can do for him.”
‘I couldn’t even see my son’s face, just his blue woollen hat,’ says Sarah.
‘It’s hard to put into words the pain we felt at losing our first child without ever having experienced the joy of getting to know him. It was like someone ripping out our hearts.’
Tragically, Ewan’s death could easily have been prevented with a simple 10 test.
Group B streptococcus is the biggest killer of newborn babies in Britain, yet we are one of the few developed countries not to screen for the infection.
A third of women carry the bacterium, which is largely harmless to adults.
It’s thought it may be contracted through eating beef or fish, though skin-to-skin transmission is more likely.
However, because of their immature immune systems, the bug’s effect on babies can be devastating. One in 300 exposed to it will develop the infection.
Spotting it early and treatment with antibiotics during labour or in the first few hours after childbirth can be life-saving and yet every year the infection kills 30 newborns.
Another 200 are left with disabilities, including cerebral palsy and blindness.
These tragedies could be avoided, says Professor Philip Steer, an obstetrician at the Chelsea & Westminster Hospital, London.
‘Group B strep is a big risk for newborn babies. Most professionals are aware of it, so antibiotics are often given as a precaution when, for example, a mother’s waters break more than 18 hours before delivery or if she develops a fever during labour.’
However, women carrying the bacterium often don’t have any symptoms because it lives in the bowel without causing problems.
‘This means there are many women who have no idea they are carriers until their babies become infected and then it’s too late,’ says Professor Steer.
‘For their sake, I think all mothers-to-be should be given a screening swab in the latter weeks of pregnancy, then they can decide whether to have antibiotics during labour.’
Previously, the UK National Screening Committee has ruled against rolling out a national screening programme on the grounds that the test used by the NHS is unreliable and could lead to pregnant women being given antibiotics unnecessarily.
The concern is that antibiotics interfere with the development of a healthy baby’s immune system, increasing the risk of asthma and other allergies.
However, the committee is due to review the decision this year and campaigners hope the availability of a new, more sensitive test for the bacterium will make them change their minds.
The current NHS test picks up around half of carriers; the new Enriched Culture Medium (ECM) test has a 90 per cent accuracy rate, says Jane Plumb, of charity Group B Strep Support.
At present, the ECM test is only available privately for 35 — it’s estimated it would cost the NHS just 10.63 per pregnant woman.
‘Since introducing national screening with these more sensitive tests, the U.S., Australia, France and Spain have seen an average 80 per cent fall in the number of newborns contracting group B strep,’ says Jane Plumb.
‘What further evidence does our Government need that a national screening programme here would save babies from death and disability’
Professor Steer agrees: ‘The ECM test, the gold standard test for group B strep, has been a great success in other countries, so there is no reason why we wouldn’t see the same results here.
‘It should be offered to all women who want the chance to protect their babies 35 to 37 weeks into pregnancy.
'Women who test positive should be offered penicillin, which will target group B strep without killing off other bacteria that might be helpful to a baby’s developing immune system.’
Sarah had heard of group B strep infection through a friend, and even asked during labour to be tested for it, but had no idea it could be fatal.
‘The midwife took a swab: the results came back positive two days later. But by then it was too late — Ewan had died.’
The results of a post-mortem examination a couple of weeks later confirmed a group B strep infection had been the cause of his death.
‘At first, I felt relieved to discover it was this, rather than a genetic condition, which had killed our son,’ says Sarah.
‘At least it would be preventable if we had another baby. But that was quickly followed by fury — a simple dose of antibiotics would have saved my son’s life.’
When Sarah missed a period four months after Ewan’s death, it was several weeks until she could face taking a pregnancy test.
‘I knew that having another baby was the only thing that would give us the strength to begin to rebuild our lives, but I was terrified that a tragedy might happen again.’
Sarah was closely monitored throughout her pregnancy and given antibiotics before the birth of her healthy baby girl, Lorna, in 2010.
Then, in January this year, the Campbells welcomed another healthy child, a boy called Scott.
‘For a long time I blamed myself for what happened to Ewan because he picked up the infection from me,’ says Sarah.
‘People tried to reassure me it wasn’t my fault — there was no reason for me to know I had group B strep.
‘We’ll do all we can to raise awareness of this condition and continue lobbying MPs until a national screening programme is introduced. That way our son’s death won’t have been in vain.’
Dr Anne Mackie, director of programmes for the UK National Screening Committee, told the Mail: ‘We welcome all research that will assist our next review in the hope that more effective screening and treatment methods can be made available.
'Losing a child in this way is a tragedy.’
For more information on Group B strep and the charity’s e-petition for pregnant women to be tested, visit gbss.org.uk