A Guide to Strep Throat and Pregnancy

Pregnancy is a period of relatively compromised immunity, which means that susceptibility to various infections is increased because the immune system is weakened. Pregnant women could come down with various bacterial or viral diseases, one of which is a strep throat infection.

This winter has seen a particular rise in different strep throat infections which has been worrying many pregnant people and those with young children.

Streptococcal infections generally present in various forms, affecting the mouth, the throat, the skin, the intestines, and the genitals. These are diseases caused by similar but different groups of bacteria called streptococci.

What Is Strep Throat Infection?

Strep throat is a bacterial infection, with a high proliferation in the United States. According to recent statistics, strep throat, also known as strep pharyngitis, is the most common bacterial form of throat infection, with  5–15% of adults and 15–35% of children in the US with a sore throat diagnosed with strep throat. 

The CDC estimated about 5.2 million annual visits for strep throat infections in the US; other research has shown that about 616 million people are affected yearly with strep pharyngitis.

Strep throat could sometimes be superimposed by a non-streptococcal or viral form of throat infection leading to complicated diagnosis and treatment.

Types of Streptococcal Infections 

Among all the variants of strep infections, two major forms stand out in pregnancy, and every pregnant person should know about them.

The first form is group B streptococcus. This is a gram-positive bacterium that colonizes the gastrointestinal and genitourinary tracts. It has been linked to both early and late-onset infections in newborns.

According to the CDC, the bacteria is passed from mother to child during childbirth, and the risk of transmission of an early-onset infection is greater in premature births. The mothers who transmit the bacteria are usually asymptomatic; therefore, a test is the only way to determine if the mother is likely to pass the infection to her child at delivery. A positive test for this group B strain means a high bacterial load.

The other form of streptococcal infection common in pregnancy is strep throat infection which is caused by streptococcus pyogenes, a group A streptococcus bacteria. It affects the throat and tonsils. 

The bacteria is also responsible for several other types of infections that affect different categories of people and are common in different seasons, such as scarlet fever or impetigo. Other group A streptococcus, such as streptococcus agalactiae is responsible for diseases like meningitis, neonatal pneumonia, and sepsis.

Symtoms of Strep Throat Infection

People that are infected with group A strep pharyngitis usually come down with symptoms that are similar to that of common cold, such as; 

• Sore throat
• Pain
• Fever
• Difficulty swallowing
• Swollen tonsils
• White spots on the palate and throat
• Loss of appetite
• Fatigue
• Headache

Whenever someone presents with a sore throat along with a cough or runny nose, the infection is less likely to be strep pharyngitis and more likely to be a viral infection.

How Does Strep Throat Infection Spread? 

Strep throat bacteria are extremely infectious. It spreads quickly in childcare facilities, schools, and other locations where people, particularly children, congregate. They are transmitted mostly through intimate contact with an infected individual.

It can also be spread through respiratory droplets by coughing and sneezing or through direct contact with a wound.

Due to its high rate of spread, the NHS, CDC.gov, and other official health bodies recommend staying home from work or school until you have no fever and have been on therapy for 12 to 24 hours.

The incubation period of the bacteria is around two to five days; therefore, it usually takes this long before an infected individual starts to show early symptoms. Some people are also asymptomatic, but they are also equally capable of transmitting the disease.

Complications of Strep Throat In Pregnancy

While pregnant, a woman may experience sore throat; and while it is not necessarily a strep throat infection, it is important to recognize the symptoms to know the necessary steps.

As explained earlier, strep pharyngitis is caused by a strain of bacteria called streptococcus pyogenes which is a group A strep strain; they are highly contagious and not to be confused with the group B streptococcus (GBS) that is asymptomatic and only spread vertically from mother to child during delivery.

The most significant worry about a strep throat infection during pregnancy is not the pharyngitis itself but the possible complication. Complications are rare and only occur when the throat infection is left untreated over a long period, allowing the bacteria to spread further into your system and causing sepsis. These complications include;

• Swollen neck lymph nodes
• Sinus infections
• Throat infection
• Rheumatic fever
• Post-streptococcal glomerulonephritis can develop due to an exaggerated immune response to the bacteria infection.

As mentioned earlier, there is no risk of complications for your baby if you contract strep throat while pregnant; it will not cause a miscarriage, and you cannot pass the group A strep to your child at delivery.

Diagnosis and Treatment

Rapid Tests and Throat Culture

After asking you a series of questions to determine if the disease is viral or a strep throat infection, your healthcare provider is likely to do a rapid strep test which helps to detect the disease quickly. After a positive rapid test, the doctor will then institute antibiotic treatment; however, if the test is negative, your physician may carry out a throat swab to culture just to be sure.

Once you have tested positive, the standard precaution from the Center for Disease Control and Prevention is that you should stay away from work until your fever is gone  or until you have used an antibiotic prescribed by your physician for 12 hours.

Treatment With Antibiotics

Strep throat infections are treated with antibiotics. They help to alleviate your symptoms, reduce the period of sickness and help you get back to work faster. 

As a pregnant woman, it is important that any drug you take during pregnancy is controlled and closely monitored because most of these medicines will cross the placenta. Some have side effects on the woman and could harm the fetus. The specific type of drug must be carefully chosen. 

Certain antibiotics are safe to use while pregnant, while others are not. The type of antibiotic, when and for how long you take it during your pregnancy, how much you take, and the probable consequences on your pregnancy are all factors that influence safety, and all of these should be taken into consideration by your healthcare provider. 

The antibiotics used to treat strep throat infection include: cephalexin, penicillin, and amoxicillin. Animal studies have demonstrated these drugs to carry no risk; however, no similar controlled studies have been done in humans yet. Due to this, the American Pregnancy Association and the FDA advise following your healthcare professional’s instructions carefully when using any of these drugs.

The choice of antibiotics prescribed to you will depend on the history you have given about your symptoms, what trimester you are in, if the benefits of prescription outweigh the risk, and if you have any allergies or resistance to any of the medicines.

Not everyone will require an antibiotic; some people are only carriers, meaning they will test positive for the infection but will not show any symptoms. These people do not need to be given any antibiotics. Also, people who have repeatedly taken antibiotics without relief of symptoms will be taken off the antibiotics as their infection is most likely viral.

How to Relieve Symptoms at Home

There are home remedies that can help alleviate your symptoms. However, you should note that these remedies do not cure the infection; they can only help you to feel better faster. 

• Gargle with warm salt water frequently to help relieve the sore throat. Make sure the water is not too hot. 
• Drink plenty of water and eat soft foods 
• Get a lot of rest to help your body recuperate faster

How To Prevent Infection and Protect Others

Whilst coming down with a strep infection while you are pregnant will likely not cause any harm to you or your growing baby, it’s worthwhile to take steps to prevent yourself from being infected. Simple steps to prevent infection include:

• Washing your hands regularly, especially after you have touched dirty surfaces
• Disposing of used tissues immediately 
• Covering your mouth when you sneeze or cough
• Educate yourself. Pregnancy has many other peculiarities, and the right pregnancy guide will help you navigate this period safely.

In conclusion, a strep throat infection is an infectious disease caused by group A strep; the infection should not be confused with those caused by group B strep that can be transferred from mother to child even though the mother is asymptomatic. 

Even though it is contagious from person to person, strep throat poses no risk to your fetus. With early presentation, good hygiene, adequate treatment, and adherence to medical advice, you do not have anything to worry about when you have strep throat.