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Updated: Jul 26, 2025
A Murine Model of Group B Streptococcus Vaginal Colonization
Published on: November 16, 2016
Mortality and neurodevelopmental outcome after invasive group B streptococcal infection in infants
Maren Mynarek1, Torstein Vik1, Guro L Andersen1,2
1Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Insights
Invasive group B streptococcal (GBS) infection in infants leads to significant mortality and long-term neurodevelopmental disorders (NDDs) in survivors. Early detection and intervention are crucial for affected children.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurodevelopmental Disorders
Background:
- Invasive group B streptococcal (GBS) infection poses a significant threat to infant health.
- Long-term consequences of GBS infection, including neurodevelopmental disorders (NDDs), require thorough investigation.
Purpose of the Study:
- To evaluate the case fatality rate (CFR), infant mortality, and incidence of long-term neurodevelopmental disorders (NDDs) following invasive GBS infection in infants.
- To identify specific NDDs associated with GBS meningitis in affected children.
Main Methods:
- A population-based cohort study included infants born in Norway between 1996 and 2019.
- Data were extracted from national registries, linking GBS infection diagnoses to mortality and NDD outcomes assessed at a mean age of 12 years and 10 months.
Main Results:
- The case fatality rate (CFR) for invasive GBS infection was 5.0%.
- Infants with GBS infection had a significantly higher risk of infant mortality (RR 19.41) and NDDs (RR 3.49).
- Among survivors, 20.7% were diagnosed with NDDs, with GBS meningitis strongly associated with ADHD, cerebral palsy, epilepsy, hearing impairment, and developmental disorders.
Conclusions:
- Invasive GBS infection in infancy results in a substantial burden of mortality and long-term neurodevelopmental sequelae.
- The findings highlight the critical need for enhanced preventive strategies and early intervention pathways for GBS-infected infants and survivors.
Aim:
To assess case fatality rate (CFR), infant mortality, and long-term neurodevelopmental disorders (NDDs) after invasive group B streptococcal (GBS; Streptococcus agalactiae) infection in infants.
Method:
Children born in Norway between 1996 and 2019 were included. Data on pregnancies/deliveries, GBS infection, NDDs, and causes of death were retrieved from five national registries. The exposure was culture-confirmed invasive GBS infection during infancy. Outcomes were mortality and NDDs, the latter at a mean age of 12 years 10 months.
Results:
Among 1 415 625 live-born children, 866 (87%) of 1007 infants diagnosed with GBS infection (prevalence 0.71 per 1000) were included. The CFR was 5.0% (n = 43). GBS infection was associated with higher infant mortality (relative risk 19.41; 95% confidence interval [CI] 14.79-25.36) than the general population. Among survivors, 169 (20.7%) children were diagnosed with any NDD (relative risk 3.49; 95% CI 3.05-3.98). In particular, GBS meningitis was associated with high risks of attention-deficit/hyperactivity disorder, cerebral palsy, epilepsy, hearing impairment, and pervasive and specific developmental disorder.
Interpretation:
The burden of invasive GBS infection during infancy is considerable and continues to affect children beyond infancy. These findings emphasize the need for new preventive strategies for disease reduction, and the need for survivors to be directly included into early detection pathways to access early intervention if required.
What This Paper Adds:
The burden of invasive group B streptococcal (GBS) infection in Norway is considerable. Of GBS infection survivors, 20.7% were diagnosed with neurodevelopmental disorders (NDDs) at mean age 12 years 10 months. Infants with GBS meningitis were more often diagnosed with NDDs. Absolute risks associated with GBS infections were highest for pervasive and specific developmental disorder, cerebral palsy, and attention-deficit/hyperactivity disorder.
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