This sheet is about having group A strep infections in pregnancy or while breastfeeding. This information is based on available published literature. It should not take the place of medical care and advice from your healthcare provider.
What are group A strep infections?
Group A strep infections are caused by a bacteria called group A Streptococcus. Group A strep infections can range from mild to severe. Mild infections include impetigo (infection of the skin causing red sores with yellow crust), scarlet fever (bright red rash on the body with a sore throat and a high fever), and strep throat (infection of the throat and tonsils). Serious infections include cellulitis (infection of the skin that can lead to infection in the bloodstream), necrotizing fasciitis (necrosis (death) of skin tissue), and streptococcal toxic shock syndrome (blood infection that causes fever and chills and leads to organ failure).
All group A strep infections can cause rheumatic fever (a disease that can develop when strep throat or scarlet fever is not properly treated with antibiotics) and kidney damage.
People who are pregnant have a higher chance of experiencing severe group A strep infections. It is important to seek care as soon as possible if you think you have a group A strep infection. A healthcare provider can order group A strep testing for you.
How do you get a group A strep infection?
Group A strep bacteria are very contagious. The bacteria spreads from person to person through touch or when it is breathed in. People can be infected with group A strep bacteria without feeling sick or knowing they’re infected.
I have a group A strep infection. Can it make it harder for me to get pregnant?
Studies have not been done to see if having a group A strep infection can make it harder to get pregnant.
Does having a group A strep infection increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. It is not known if group A strep infections increase the chance for miscarriage. Two studies of less than 100 people reported an increased chance for miscarriage in people who are pregnant and have a group A strep infection. There was little information on how severe their illness was, or what symptoms they were having, in the study reports. As there can be many causes of miscarriage, it is hard to know if the infection or other factors are the cause of a miscarriage.
Does having a group A strep infection increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. Studies have not been done to see if having a group A strep infection increases the chance for birth defects.
Fever is a possible symptom of some group A strep infections. A high fever in the first trimester can increase the chance of certain birth defects. Acetaminophen has been recommended as an option to reduce fever in pregnancy. If you have a group A strep infection and develop a fever, talk with your healthcare provider about the best way to treat your fever. For more information about fever and pregnancy, see the MotherToBaby fact sheet about fever/hyperthermia at https://mothertobaby.org/fact-sheets/hyperthermia-pregnancy/ and a fact sheet on acetaminophen here: https://mothertobaby.org/fact-sheets/acetaminophen-pregnancy/.
Does having a group A strep infection increase the chance of other pregnancy-related problems?
Studies have not been done to see if having a group A strep infection can increase the chance of preterm delivery (birth before week 37) or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth). Two studies of less than 100 people reported an increased chance of stillbirth in people who were pregnant and had a group A strep infection. This is not enough information to draw a conclusion about group A strep infection and the chance of stillbirth.
Group A strep infections that happen near or during labor can lead to serious disease. An infant who has a group A strep infection can develop streptococcal toxic shock syndrome (serious medical condition where bacteria get into the blood and leads to organ failure).
Can group A strep infections be passed to the fetus during pregnancy or at the time of delivery?
There have been no reports of group A strep infections being passed to the fetus during pregnancy. However, newborns can get group A strep infections at delivery or soon after delivery if they are exposed to group A strep bacteria. If you have been diagnosed with group A strep, talk with your healthcare provider and baby’s pediatrician to ensure your baby gets the care they need.
Does having a group A infection in pregnancy affect future behavior or learning for the child?
It is not known if exposure to a group A strep infection in pregnancy can affect future behavior or learning for the child. One study did not find any changes in learning or behavior in children 0 to 5 years old whose parent had a group A infection while pregnant.
Breastfeeding while I have a group A strep infection:
Group A strep bacteria pass into breast milk. There is no information on what effect, if any, group A strep bacteria in breast milk might have on a breastfed infant. People with group A strep infections may feel too sick to breastfeed and may have a lower supply than normal. Your healthcare provider might recommend that you continue to express milk when possible. There are no specific recommendations about breastfeeding when infected with group A strep.
While sick, it is important to try to protect your baby from getting sick. Wash your hands with soap and water before holding your baby. Avoid coughing or sneezing on the baby. Cover your mouth/nose with a tissue when you cough or sneeze, then throw away the tissue and wash your hands. While you are ill, you may want to consider having someone who is not sick help you care for your baby. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a male has a group A strep infection, can it affect male fertility or increase the chance of birth defects?
Studies have not been done to see if a group A strep infection could affect male fertility (ability to get partner pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase the risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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OTIS/MotherToBaby encourages inclusive and person-centered language. While our name still contains a reference to mothers, we are updating our resources with more inclusive terms. Use of the term mother or maternal refers to a person who is pregnant. Use of the term father or paternal refers to a person who contributes sperm.
