Neonatal Encephalopathy With Group B Streptococcal Disease Worldwide: Systematic Review, Investigator Group Datasets, and Meta-analysis

Details

• Alternative Title:
  The Burden of Group B Streptococcus Worldwide for Pregnant Women, Stillbirths, and Children
• Personal Author:
  Tann, Cally J ; Martinello, Kathryn A ; Sadoo, Samantha ; Lawn, Joy E ; Seale, Anna C ; Vega-Poblete, Maira ; Russell, Neal J ; Baker, Carol J ; Bartlett, Linda ; Cutland, Clare ; Gravett, Michael G ; Ip, Margaret ; Le Doare, Kirsty ; Madhi, Shabir A ; Rubens, Craig E ; Saha, Samir K ; Schrag, Stephanie ; Sobanjo-ter Meulen, Ajoke ; Vekemans, Johan ; Heath, Paul T
• Corporate Authors:
  for the GBS Neonatal Encephalopathy Investigator Group Garcia-AlixAlfredoBooNem-YunMartinez-BiargeMiriamCheongJeanieCowanFrancesde VriesLinda SArca-DiazGemmaEdwardsA DavidEllisMatthewGaleChristopherGlassHannah CGroenendaalFlorisGunnAlistairHayesBredaJacobsSusan EJohnsonClark TKaliGuguManneManognaMassaroAn NRobertsonNicola JShahPrakeshkumarShankaranSeethaTannCally JThayyilSudhinThoresenMarianneWalshBrian HWintermarkPiaLeeAnne C C
• Description:
  Background
  
  Neonatal encephalopathy (NE) is a leading cause of child mortality and longer-term impairment. Infection can sensitize the newborn brain to injury; however, the role of group B streptococcal (GBS) disease has not been reviewed. This paper is the ninth in an 11-article series estimating the burden of GBS disease; here we aim to assess the proportion of GBS in NE cases.
  
  Methods
  
  We conducted systematic literature reviews (PubMed/Medline, Embase, Latin American and Caribbean Health Sciences Literature LILACS, World Health Organization Library Information System WHOLIS, and Scopus) and sought unpublished data from investigator groups reporting GBS-associated NE. Meta-analyses estimated the proportion of GBS disease in NE and mortality risk. UK population-level data estimated the incidence of GBS-associated NE.
  
  Results
  
  Four published and 25 unpublished datasets were identified from 13 countries (N = 10436). The proportion of NE associated with GBS was 0.58% (95% confidence interval CI, 0.18%–.98%). Mortality was significantly increased in GBS-associated NE vs NE alone (risk ratio, 2.07 95% CI, 1.47–2.91). This equates to a UK incidence of GBS-associated NE of 0.019 per 1000 live births.
  
  Conclusions
  
  The consistent increased proportion of GBS disease in NE and significant increased risk of mortality provides evidence that GBS infection contributes to NE. Increased information regarding this and other organisms is important to inform interventions, especially in low- and middle-resource contexts.
• Subjects:
  • Brain Diseases
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Newborn, Diseases
  • Risk Factors
  • Streptococcal Infections
  • Streptococcus agalactiae
• Source:
  Clin Infect Dis. 2017; 65(Suppl 2):S173-S189
• Pubmed ID:
  29117330
• Pubmed Central ID:
  PMC5850525
• Document Type:
  Journal Article
• Funding:
  205184/Z/16/Z/WT_/Wellcome Trust/United Kingdom ; MR/K006355/1/MRC_/Medical Research Council/United Kingdom ; G0100126/MRC_/Medical Research Council/United Kingdom ; G0200270/MRC_/Medical Research Council/United Kingdom ; 001/WHO_/World Health Organization/International ; MR/N008405/1/MRC_/Medical Research Council/United Kingdom
• Volume:
  65
• Download URL:
  https://stacks.cdc.gov/view/cdc/52796/cdc_52796_DS1.pdf
• File Type:
  [PDF - 6.14 MB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:714bd078372159fd74a70e6f119402260375adb2292c863209dab450aefc7762aae847806917a241326205e0dbec2bcd2d25cc1d9500dbce10dcebcb482f942c