Long-term outcomes after group B streptococcus infection: a cohort study
Kee Thai Yeo1,2, Monica Lahra3, Barbara Bajuk4
1Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.
Insights
Group B Streptococcus (GBS) infection in infancy increases a child's risk of death and hospitalisation into adolescence. Survivors face ongoing health issues, including neurological and genitourinary problems, necessitating long-term care.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Health
- Epidemiology
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal infections.
- Understanding the long-term health sequelae of GBS infection is crucial for pediatric care.
Purpose of the Study:
- To determine the long-term risk of mortality and hospitalisation in children following infant GBS infection.
- To identify specific health outcomes associated with GBS infection in childhood.
Main Methods:
- A population-based cohort study was conducted in New South Wales, Australia.
- Live births between 2000 and 2011 were analyzed, comparing outcomes of children with and without GBS infection diagnoses.
- International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) codes were used for GBS identification.
Main Results:
- Infants with GBS infection had higher rates of prematurity, low birth weight, and lower Apgar scores.
- Children with GBS infection showed a threefold increased adjusted odds of death and rehospitalisation.
- GBS survivors experienced more frequent and longer hospitalisations, with increased risks of genitourinary and nervous system issues.
Conclusions:
- Despite declining GBS infection rates, the long-term health risks for affected children remain elevated, particularly in the first five years of life.
- Survivors of GBS infection are at higher risk for chronic conditions, including cerebral palsy and epilepsy, requiring ongoing medical management.
Objective:
To describe the risk of death and hospitalisation until adolescence of children after group B streptococcus (GBS) infection during infancy.
Design:
Population-based cohort study.
Setting:
New South Wales, Australia.
Patients:
All registered live births from 2000 to 2011.
Interventions:
Comparison of long-term outcomes in children with the International Statistical Classification of Diseases and Related Health Problems-10th Revision discharge codes corresponding to GBS infections and those without.
Main Outcome Measures:
Death and hospitalisation.
Results:
A total of 1206 (0.1%) children (936 (77.6%)≥37 weeks' gestation) were diagnosed with GBS infection. Over the study period, infection rates decreased from 2.1 (95% CI 1.8 to 2.4) to 0.7 (95% CI 0.5 to 0.9) per 1000 live births. Infants with GBS infection were born at lower gestation (mean 37.6 vs 39.0 weeks), were more likely very low birth weight (<1500 g, OR 9.1(95% CI 7.4 to 11.3)), born premature (OR 3.9(95% CI 3.4 to 4.5)) and have 5 min Apgar scores ≤5 (OR 6.7(95% CI 5.1 to 8.8)). Children with GBS had three times the adjusted odds of death (adjusted OR (AOR) 3.0(95% CI 2.1 to 4.3)) or rehospitalisations (AOR 3.1(95% CI 2.7 to 3.5)). Thirty-six (3.0%) with GBS died, with >50% of deaths occurring <28 days. Children with GBS were hospitalised more frequently (median 2 vs 1), for longer duration (mean 3.7 vs 2.2 days) and were at higher risk for problems with genitourinary (OR 3.1(95% CI 2.8 to 3.5)) and nervous (OR 2.0 (95% CI1.7 to 2.3)) systems.
Conclusions:
Despite decreasing GBS rates, the risk of poor health outcomes for GBS-infected children remains elevated, especially during the first 5 years. Survivors continue to be at increased risk of death and chronic conditions requiring hospitalisations, such as cerebral palsy and epilepsy.
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