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Published on: November 16, 2016
South Indian Children's Neurodevelopmental Outcomes After Group B Streptococcus Invasive Disease: A Matched-Cohort
Hima B John1, Asha Arumugam1, Mohana Priya1
1Department of Neonatology, Christian Medical College, Vellore, India.
Insights
Children exposed to invasive group B Streptococcus (iGBS) show a higher risk of developing motor impairments. This study compared neurodevelopmental impairment in iGBS survivors versus a matched non-iGBS group.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Developmental Psychology
Background:
- Invasive group B Streptococcus (iGBS) infection can lead to long-term neurodevelopmental impairment (NDI) in children.
- Estimating the precise risk of NDI following iGBS is crucial for early intervention and management.
- This study focuses on a South Indian population to assess NDI in iGBS survivors.
Purpose of the Study:
- To compare neurodevelopmental outcomes across multiple domains in children who survived invasive group B Streptococcus (iGBS).
- To evaluate the risk of long-term neurodevelopmental impairment (NDI) in iGBS survivors against a matched cohort without iGBS.
- To identify specific areas of developmental delay or impairment associated with iGBS exposure.
Main Methods:
- A matched-cohort study design was employed, comparing iGBS survivors with age- and gender-matched controls.
- Neurodevelopmental assessments utilized standardized tools including BSID-III, WPPSI-IV, WISC-V, CBCL, and BOT-2, tailored to participant age.
- Data were collected from January 2020 to April 2021 in a South Indian hospital setting.
Main Results:
- The cohort included 35 iGBS-exposed children and 65 matched non-iGBS controls (ages 1-14 years).
- Children with iGBS showed a statistically significant higher risk of motor impairments (unadjusted OR, 10.7; P=.034) compared to controls.
- While impairments in at least one domain were observed in 48.6% of iGBS survivors versus 38% of controls, motor deficits were particularly pronounced.
Conclusions:
- Children with a history of invasive group B Streptococcus (iGBS) infection exhibit an elevated risk of developing motor impairments.
- These findings underscore the importance of targeted neurodevelopmental surveillance for iGBS survivors, especially for motor function.
- Further research may elucidate the mechanisms underlying iGBS-related motor deficits and inform preventative strategies.
Background:
This study is part of a multicountry matched-cohort study designed to estimate the risk of long-term neurodevelopmental impairment (NDI) of children exposed to invasive group B Streptococcus (iGBS). The specific objective of this paper is to compare NDI across domains of iGBS survivors with a matched non iGBS group in our population.
Methods:
Survivors of iGBS in a South Indian hospital were identified and recruited between January 2020 and April 2021. Cases were compared with age- and gender-matched non iGBS children. Participants were assessed using Bayley Scales of Infant and Toddler Development-3rd edition (BSID-III), Wechsler Preschool and Primary Scale of Intelligence-4th edition (WPPSI-IV), Wechsler Intelligence Scale for Children-5th edition (WISC-V), Child Behavior Checklist (CBCL), and Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2), depending on age.
Results:
Our cohort comprised 35 GBS-exposed and 65 matched non iGBS children, aged 1-14 years. The iGBS-exposed group had 17 (48.6%) children with impairment in ≥1 domain compared to 25 (38%) in the non iGBS group (unadjusted OR, 1.51; 95% CI, .65-3.46), 9 (26%) children with "multi-domain impairment" compared to 10 (15.4%) in the non iGBS group (unadjusted OR, 1.90; 95% CI, .69-5.24), and 1 (2.9%) child with moderate to severe impairment compared to 3 (4.6%) in the non iGBS group (unadjusted OR, .60; 95% CI, .06-6.07). In the iGBS group, more children had motor impairments compared with the non iGBS group (unadjusted OR, 10.7; 95% CI, 1.19-95.69; P = .034).
Conclusions:
Children with iGBS seem at higher risk of developing motor impairments compared with a non iGBS group.
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