How maternal infections cause birth injuries
A maternal infection becomes a birth injury when an infection the mother carries, often silently and harmlessly for her, reaches the baby before or during delivery and causes sepsis, meningitis, pneumonia, or brain injury that screening and treatment were designed to prevent. This is one of the most protocol-driven areas in all of obstetrics: for the major infections, professional bodies have published exactly when to test, what to test, and what to do with a positive result.
That is what makes these cases different from many birth injury claims. The question is rarely a judgment call made in a chaotic delivery room. It is usually simpler: Was the screening test done on schedule? Was the result seen? Was the treatment given? Each answer is in the prenatal and labor records.
Group B strep: the universal screening standard
Group B Streptococcus (GBS) is a common bacterium carried, without symptoms, by roughly one in four pregnant women. Harmless to the mother, it can be devastating to a newborn who acquires it during delivery; GBS remains a leading cause of newborn sepsis and meningitis.
Because carriage is invisible, the standard of care is universal screening: a vaginal-rectal culture for every pregnant woman at 36 0/7 to 37 6/7 weeks of pregnancy (ACOG moved the window from 35–37 weeks in 2019 so results stay valid through more due dates). A positive mother receives intravenous antibiotics (penicillin is first-line) during labor, ideally beginning at least four hours before delivery. If a woman arrives in labor with unknown GBS status, risk factors (preterm labor, membranes ruptured more than 18 hours, fever) trigger antibiotics anyway.
The recurring failures: the culture never collected; a positive result filed but never flagged; antibiotics ordered but started too late in labor; unknown-status risk factors ignored; or a documented GBS-positive history from a prior pregnancy never acted on. Each is a departure from a bright-line, published protocol.
Genital herpes (HSV) management
Neonatal herpes is rare but catastrophic: disseminated infection and HSV encephalitis kill or disable a large share of affected newborns even with treatment. The tragedy is that transmission is largely preventable, and the prevention rules are explicit (ACOG Practice Bulletin 220):
- Ask. Providers are expected to take a genital herpes history from every pregnant patient and her partner.
- Suppress. Women with a known history are offered suppressive antiviral therapy (acyclovir or valacyclovir) from 36 weeks to reduce outbreaks at delivery.
- Examine and divert. At labor, a woman with a history is examined; active genital lesions or warning (prodromal) symptoms indicate cesarean delivery, which sharply lowers transmission.
- Protect the exposed newborn. Babies delivered through possible active infection require defined evaluation and, when indicated, prompt intravenous acyclovir; delay measurably worsens outcomes.
Failures at any step are the fact patterns behind most neonatal herpes lawsuits: no history taken, no suppression offered, a vaginal delivery despite lesions, a sick newborn whose HSV testing was delayed while “ruling out” everything else.
Untreated UTIs and the chorioamnionitis link
Urinary tract infections are among the most common infections of pregnancy, and pregnancy makes them uniquely dangerous: even asymptomatic bacteriuria (bacteria in the urine with no symptoms at all) is associated with pyelonephritis (kidney infection) and preterm birth if untreated. That is why the U.S. Preventive Services Task Force recommends urine-culture screening in early pregnancy, and why treating a positive culture is basic prenatal care.
Left untreated, urinary and vaginal infections also feed the pathway this cluster of pages traces: ascending infection can trigger preterm labor, premature rupture of membranes, and intra-amniotic infection (chorioamnionitis), which threatens the baby with sepsis and brain injury. A dismissed UTI complaint in the second trimester and a septic newborn months later can be links in the same documented chain.
Screening standards at a glance
| Infection | Screening / management standard | Risk to the baby if missed |
|---|---|---|
| Group B strep (GBS) | Universal vaginal-rectal culture at 36 0/7–37 6/7 weeks; IV penicillin in labor if positive; risk-based antibiotics if status unknown | Sepsis, pneumonia, meningitis; death or brain injury |
| Genital herpes (HSV) | History from every patient; suppressive antivirals from 36 weeks; cesarean if active lesions or prodrome at labor | Neonatal herpes: disseminated infection, encephalitis |
| Urinary tract infection / asymptomatic bacteriuria | Urine culture screening in early pregnancy; antibiotic treatment of positives; follow-up cultures | Pyelonephritis, preterm birth, low birth weight |
| Intra-amniotic infection (chorioamnionitis) | Fever criteria monitoring in labor; prompt intrapartum IV antibiotics; newborn sepsis evaluation | Neonatal sepsis, meningitis; elevated cerebral palsy risk |
Screening tests leave a paper trail — and so do the gaps. Whether a GBS culture was collected, a herpes history was taken, or a urine culture was followed up is answerable from your prenatal records. Our attorneys review them at no cost to your family.
What infection can do to a newborn
Newborn immune systems are immature, and infections that would be trivial in an older child can overwhelm a baby in hours. Neonatal sepsis and meningitis can cause death, hearing loss, hydrocephalus, seizures, and permanent brain injury; survivors may be later diagnosed with developmental disability or cerebral palsy. Infection and fever during labor also lower a baby’s reserve, so infection cases often overlap with oxygen-deprivation injuries like HIE. And infection is a major driver of premature birth, with all the risks prematurity carries. The common thread: with each of these pathways, earlier recognition and treatment measurably changes the outcome.
Was it preventable?
An infection-related injury is not automatically malpractice. Screening tests can be properly done and still miss late-acquired colonization; some newborns become ill despite textbook prophylaxis. The legal analysis follows the protocol: Was the right test done in the right window? Was the result communicated and acted on? Were labor antibiotics started on time? Was the newborn evaluated promptly once risk was known? When the answer to one of those is no, and the injury matches the missed step, the case is about a broken protocol, not a judgment call.
Legal options for families
Maternal infection claims may name the obstetric practice (missed screening or treatment during pregnancy), the delivery hospital (labor management, antibiotic timing), and the pediatric team (delayed newborn evaluation). Compensation can cover the lifetime cost of caring for a child injured by sepsis or meningitis (projected through a life care plan), and published settlements in newborn infection cases have ranged widely with injury severity; see our settlements guide. Filing deadlines vary by state and can be short for a parent’s own claim.
Where a claim is filed depends on where the care happened. Banville Law attorneys are licensed in New York and Washington, D.C., and New York families can start with our New York birth injury guide; The Weitz Firm attorneys are licensed in Pennsylvania and New Jersey. In other states, the alliance connects families with its vetted network of local birth injury attorneys.
Frequently asked questions
I was never tested for group B strep. Is that negligence?
Universal GBS screening at 36–37 weeks has been the standard of care for years. If you delivered at or near term with no culture collected and no risk-based antibiotics in labor, that omission deserves review, especially if your baby developed a GBS infection.
I tested GBS positive. Why did my baby still get sick?
Intrapartum antibiotics dramatically reduce, but do not eliminate, early GBS disease, and they only work if given on time. The records will show whether penicillin was started promptly in labor and whether your baby was properly evaluated afterward. Late-onset GBS disease (after the first week) can occur despite perfect labor care.
No one ever asked me about herpes. Does that matter?
Yes. Taking a genital herpes history from every pregnant patient is part of the standard of care, because it triggers suppressive therapy at 36 weeks and a lesion check at labor. A history never taken means those protections were never in play.
Can an untreated UTI really cause a premature birth?
The association is well established: even symptomless bacteria in the urine are linked to kidney infection and preterm birth, which is why early-pregnancy urine culture screening is recommended. Whether an untreated infection caused a particular preterm delivery is a causation question for expert review.
What does a case review cost?
Nothing. Case reviews are free, and birth injury cases are handled on contingency; attorney fees are paid out of a recovery, never up front.
Sources
- American College of Obstetricians and Gynecologists. Committee Opinion No. 797: Prevention of Group B Streptococcal Early-Onset Disease in Newborns. Obstetrics & Gynecology. 2020;135(2):e51–e72.
- Verani JR, McGee L, Schrag SJ; CDC. Prevention of perinatal group B streptococcal disease: revised guidelines. MMWR Recommendations and Reports. 2010;59(RR-10):1–36.
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 220: Management of Genital Herpes in Pregnancy. Obstetrics & Gynecology. 2020;135(5):e193–e202.
- US Preventive Services Task Force. Screening for Asymptomatic Bacteriuria in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2019;322(12):1188–1194.
- American College of Obstetricians and Gynecologists. Committee Opinion No. 712: Intrapartum Management of Intraamniotic Infection. Obstetrics & Gynecology. 2017;130(2):e95–e101.
- Kimberlin DW; American Academy of Pediatrics. Guidance on Management of Asymptomatic Neonates Born to Women With Active Genital Herpes Lesions. Pediatrics. 2013;131(2):e635–e646.
This page is for general education and is not medical advice. Medical facts above are drawn from the cited primary sources; legal statements reflect the reviewing attorneys’ professional experience. Always consult your child’s physician about medical concerns.