Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in context
Summary: Background: Group B Streptococcus (GBS) is a leading infectious cause of neonatal morbidity and mortality worldwide, yet data on longer-term outcomes in children remain limited. We aimed to assess the risk of neurodevelopmental impairments (NDIs) in GBS survivors and to explore effect modi...
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Elsevier
2025-08-01
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| Series: | The Lancet Regional Health. Americas |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2667193X25001802 |
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| author | Romina Fakhraei Deshayne B. Fell Darine El-Chaâr Nisha Thampi Beate Sander Kevin Antoine Brown Natasha Crowcroft Shelly Bolotin Jon Barrett Elizabeth K. Darling Nahuel Fittipaldi Theresa Lamagni Allison McGeer Michelle Murti Manish Sadarangani Kevin L. Schwartz Abdool Yasseen Matthew Tunis William Petrcich Kumanan Wilson |
| author_facet | Romina Fakhraei Deshayne B. Fell Darine El-Chaâr Nisha Thampi Beate Sander Kevin Antoine Brown Natasha Crowcroft Shelly Bolotin Jon Barrett Elizabeth K. Darling Nahuel Fittipaldi Theresa Lamagni Allison McGeer Michelle Murti Manish Sadarangani Kevin L. Schwartz Abdool Yasseen Matthew Tunis William Petrcich Kumanan Wilson |
| author_sort | Romina Fakhraei |
| collection | DOAJ |
| description | Summary: Background: Group B Streptococcus (GBS) is a leading infectious cause of neonatal morbidity and mortality worldwide, yet data on longer-term outcomes in children remain limited. We aimed to assess the risk of neurodevelopmental impairments (NDIs) in GBS survivors and to explore effect modification by sex and prematurity. Methods: We performed a population-based cohort study of liveborn infants in Ontario between April 2012 and March 2018, using linked birth registry, laboratory, and health administrative databases. GBS disease in the first year of life was ascertained through culture results and diagnostic codes. NDIs, encompassing cognitive, motor, sensory (hearing, vision), and social/behavioural domains, were ascertained up to five years of age using diagnostic codes. Cox regression was used to estimate adjusted hazard ratios (aHR) for overall, domain-specific, and multidomain NDIs, comparing children with and without GBS disease during infancy. Findings: Of 764,934 infants, 771 had a history of GBS disease. GBS survivors had a twofold increased risk of any NDI (adjusted hazard ratio [aHR]: 2.18 [95% CI: 1.88, 2.54]) and higher rates of cognitive (aHR: 2.79 [95% CI: 2.37, 3.30]), motor (aHR: 7.08 [95% CI: 2.93, 17.08]), social/behavioural (aHR: 1.60 [95% CI: 1.20, 2.14]), and sensory (aHR: 1.64 [95% CI: 1.02, 2.64]) impairments. Male children and those born preterm (<37 weeks) had disproportionately higher risks of GBS-associated NDIs. Interpretation: GBS disease in infancy is associated with a higher risk of NDIs by age five years, particularly for male children and those born preterm. Primary prevention strategies are needed to mitigate long-term developmental impacts of early-life GBS disease. Funding: Canadian Institutes of Health Research. |
| format | Article |
| id | doaj-art-44825dcfec6d439aa579280ce395eb4b |
| institution | Kabale University |
| issn | 2667-193X |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Americas |
| spelling | doaj-art-44825dcfec6d439aa579280ce395eb4b2025-08-20T03:30:41ZengElsevierThe Lancet Regional Health. Americas2667-193X2025-08-014810117010.1016/j.lana.2025.101170Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in contextRomina Fakhraei0Deshayne B. Fell1Darine El-Chaâr2Nisha Thampi3Beate Sander4Kevin Antoine Brown5Natasha Crowcroft6Shelly Bolotin7Jon Barrett8Elizabeth K. Darling9Nahuel Fittipaldi10Theresa Lamagni11Allison McGeer12Michelle Murti13Manish Sadarangani14Kevin L. Schwartz15Abdool Yasseen16Matthew Tunis17William Petrcich18Kumanan Wilson19University of Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, Canada; Corresponding author. University of Ottawa, Canada.University of Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, CanadaUniversity of Ottawa, Canada; Ottawa Hospital Research Institute, CanadaUniversity of Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, CanadaUniversity of Toronto, Canada; University Health Network, Canada; ICES, Ontario, CanadaUniversity of Toronto, Canada; ICES, Ontario, Canada; Public Health Ontario, CanadaUniversity of Toronto, CanadaUniversity of Toronto, Canada; Public Health Ontario, CanadaMcMaster University, CanadaMcMaster University, CanadaUniversité de Montréal, CanadaUK Health Security Agency, United KingdomMount Sinai Hospital, CanadaUniversity of Toronto, CanadaUniversity of British Columbia, Canada; BC Children's Hospital Research Institute, CanadaUniversity of Toronto, Canada; ICES, Ontario, Canada; Public Health Ontario, Canada; Li Ka Shing Knowledge Institute, Unity Health Toronto, CanadaUniversity of Toronto, Canada; Public Health Ontario, CanadaPublic Health Agency of Canada, CanadaICES, Ontario, CanadaThe Ottawa Hospital, Canada; Bruyère Health Research Institute, Canada; Department of Medicine, University of Ottawa, CanadaSummary: Background: Group B Streptococcus (GBS) is a leading infectious cause of neonatal morbidity and mortality worldwide, yet data on longer-term outcomes in children remain limited. We aimed to assess the risk of neurodevelopmental impairments (NDIs) in GBS survivors and to explore effect modification by sex and prematurity. Methods: We performed a population-based cohort study of liveborn infants in Ontario between April 2012 and March 2018, using linked birth registry, laboratory, and health administrative databases. GBS disease in the first year of life was ascertained through culture results and diagnostic codes. NDIs, encompassing cognitive, motor, sensory (hearing, vision), and social/behavioural domains, were ascertained up to five years of age using diagnostic codes. Cox regression was used to estimate adjusted hazard ratios (aHR) for overall, domain-specific, and multidomain NDIs, comparing children with and without GBS disease during infancy. Findings: Of 764,934 infants, 771 had a history of GBS disease. GBS survivors had a twofold increased risk of any NDI (adjusted hazard ratio [aHR]: 2.18 [95% CI: 1.88, 2.54]) and higher rates of cognitive (aHR: 2.79 [95% CI: 2.37, 3.30]), motor (aHR: 7.08 [95% CI: 2.93, 17.08]), social/behavioural (aHR: 1.60 [95% CI: 1.20, 2.14]), and sensory (aHR: 1.64 [95% CI: 1.02, 2.64]) impairments. Male children and those born preterm (<37 weeks) had disproportionately higher risks of GBS-associated NDIs. Interpretation: GBS disease in infancy is associated with a higher risk of NDIs by age five years, particularly for male children and those born preterm. Primary prevention strategies are needed to mitigate long-term developmental impacts of early-life GBS disease. Funding: Canadian Institutes of Health Research.http://www.sciencedirect.com/science/article/pii/S2667193X25001802Group B StreptococcusStreptococcus agalactiaeNeurodevelopmental impairmentsEffect modificationSex differencesPrematurity |
| spellingShingle | Romina Fakhraei Deshayne B. Fell Darine El-Chaâr Nisha Thampi Beate Sander Kevin Antoine Brown Natasha Crowcroft Shelly Bolotin Jon Barrett Elizabeth K. Darling Nahuel Fittipaldi Theresa Lamagni Allison McGeer Michelle Murti Manish Sadarangani Kevin L. Schwartz Abdool Yasseen Matthew Tunis William Petrcich Kumanan Wilson Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in context The Lancet Regional Health. Americas Group B Streptococcus Streptococcus agalactiae Neurodevelopmental impairments Effect modification Sex differences Prematurity |
| title | Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in context |
| title_full | Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in context |
| title_fullStr | Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in context |
| title_full_unstemmed | Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in context |
| title_short | Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, CanadaResearch in context |
| title_sort | group b streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children a population based cohort study in ontario canadaresearch in context |
| topic | Group B Streptococcus Streptococcus agalactiae Neurodevelopmental impairments Effect modification Sex differences Prematurity |
| url | http://www.sciencedirect.com/science/article/pii/S2667193X25001802 |
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