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Updated: Sep 29, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Group B Streptococcus Infection in Extremely Preterm Neonates and Neurodevelopmental Outcomes at 2 Years
Karen M Puopolo1,2,3, Sagori Mukhopadhyay1,2,3, Nellie I Hansen4
1Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Insights
Group B Streptococcus (GBS) disease incidence in extremely preterm infants remained stable. Early-onset GBS infection increased the risk of death or neurodevelopmental impairment, highlighting the need for new prevention strategies.
Area of Science:
- Neonatalogy
- Infectious Diseases
- Epidemiology
Background:
- Group B Streptococcus (GBS) poses a significant threat to extremely preterm infants.
- Understanding the incidence and outcomes of GBS disease in this vulnerable population is crucial.
Purpose of the Study:
- To determine the incidence of GBS disease in extremely preterm infants.
- To assess the risk of death or neurodevelopmental impairment (NDI) associated with GBS disease.
Main Methods:
- Observational cohort study using a multicenter registry.
- Inclusion criteria: infants born at 22-28 weeks gestation, surviving >12 hours.
- GBS disease defined by positive blood or CSF cultures within 72 hours (early-onset) or after 72 hours (late-onset).
Main Results:
- Incidence of GBS early-onset disease (EOD) and late-onset disease (LOD) did not change significantly over time.
- GBS EOD was associated with a higher risk of death/NDI compared to other infections or no infection.
- GBS LOD increased the risk of death among infants surviving >30 days.
Conclusions:
- The incidence of GBS disease in extremely preterm infants has not changed.
- GBS EOD significantly increases the risk of death or NDI.
- Novel preventive strategies are needed to reduce GBS disease burden and improve outcomes.
Background:
This study was performed to determine the incidence of group B Streptococcus (GBS) disease among extremely preterm infants and assess to risk of death or neurodevelopmental impairment (NDI) at a corrected age of 18-26 months.
Methods:
In this observational cohort study of infants enrolled in a multicenter registry, the incidence of GBS disease was assessed in infants born in 1998-2016 at 22-28 weeks' gestation and surviving for >12 hours. The composite outcome, death or NDI, was assessed in infants born in 1998-2014 at 22-26 weeks' gestation. Infection was defined as GBS isolation in blood or cerebrospinal fluid culture at ≤72 hours (early-onset disease [EOD]) or >72 hours (late-onset disease [LOD]) after birth. Using Poisson regression models, the outcome was compared in infants with GBS disease, infants infected with other pathogens, and uninfected infants.
Results:
The incidence of GBS EOD (2.70/1000 births [95% confidence interval (CI), 2.15-3.36]) and LOD (8.47/1000 infants [7.45-9.59]) did not change significantly over time. The adjusted relative risk of death/NDI was higher among infants with GBS EOD than in those with other infections (adjusted relative risk, 1.22 [95% CI, 1.02-1.45]) and uninfected infants (1.44 [1.23-1.69]). Risk of death/NDI did not differ between infants with GBS LOD and comparator groups. GBS LOD occurred at a significantly later age than non-GBS late-onset infection. Among infants surviving >30 days, the risk of death was higher with GBS LOD (adjusted relative risk, 1.90 [95% CI, 1.36-2.67]), compared with uninfected infants.
Conclusions:
In a cohort of extremely preterm infants, the incidence of GBS disease did not change during the study period. The increased risk of death or NDI with GBS EOD, and of death among some infants with GBS LOD, supports the need for novel preventive strategies for disease reduction.
Clinical Trials Registration:
NCT00063063.
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