RT Journal Article
SR Electronic
T1 Long-term outcomes after group B streptococcus infection: a cohort study
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 172
OP 178
DO 10.1136/archdischild-2017-314642
VO 104
IS 2
A1 Kee Thai Yeo
A1 Monica Lahra
A1 Barbara Bajuk
A1 Lisa Hilder
A1 Mohamed E Abdel-Latif
A1 Ian M Wright
A1 Ju-Lee Oei
YR 2019
UL http://adc.bmj.com/content/104/2/172.abstract
AB 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.