PMID- 33894156
OWN - NLM
STAT- MEDLINE
DCOM- 20210726
LR  - 20210726
IS  - 2352-4650 (Electronic)
IS  - 2352-4642 (Print)
IS  - 2352-4642 (Linking)
VI  - 5
IP  - 6
DP  - 2021 Jun
TI  - Mortality, neurodevelopmental impairments, and economic outcomes after invasive 
      group B streptococcal disease in early infancy in Denmark and the Netherlands: a 
      national matched cohort study.
PG  - 398-407
LID - S2352-4642(21)00022-5 [pii]
LID - 10.1016/S2352-4642(21)00022-5 [doi]
AB  - BACKGROUND: Group B Streptococcus (GBS) disease is a leading cause of neonatal 
      death, but its long-term effects have not been studied after early childhood. The 
      aim of this study was to assess long-term mortality, neurodevelopmental 
      impairments (NDIs), and economic outcomes after infant invasive GBS (iGBS) 
      disease up to adolescence in Denmark and the Netherlands. METHODS: For this 
      cohort study, children with iGBS disease were identified in Denmark and the 
      Netherlands using national medical and administrative databases and culture 
      results that confirmed their diagnoses. Exposed children were defined as having a 
      history of iGBS disease (sepsis, meningitis, or pneumonia) by the age of 89 days. 
      For each exposed child, ten unexposed children were randomly selected and matched 
      by sex, year and month of birth, and gestational age. Mortality data were 
      analysed with the use of Cox proportional hazards models. NDI data up to 
      adolescence were captured from discharge diagnoses in the National Patient 
      Registry (Denmark) and special educational support records (the Netherlands). 
      Health care use and household income were also compared between the exposed and 
      unexposed cohorts. FINDINGS: 2258 children-1561 in Denmark (born from Jan 1, 1997 
      to Dec 31, 2017) and 697 in the Netherlands (born from Jan 1, 2000 to Dec 31, 
      2017)-were identified to have iGBS disease and followed up for a median of 14 
      years (IQR 7-18) in Denmark and 9 years (6-11) in the Netherlands. 366 children 
      had meningitis, 1763 had sepsis, and 129 had pneumonia (in Denmark only). These 
      children were matched with 22 462 children with no history of iGBS disease. iGBS 
      meningitis was associated with an increased mortality at age 5 years (adjusted 
      hazard ratio 4.08 [95% CI 1.78-9.35] for Denmark and 6.73 [3.76-12.06] for the 
      Netherlands). Any iGBS disease was associated with an increased risk of NDI at 10 
      years of age, both in Denmark (risk ratio 1.77 [95% CI 1.44-2.18]) and the 
      Netherlands (2.28 [1.64-3.17]). A history of iGBS disease was associated with 
      more frequent outpatient clinic visits (incidence rate ratio 1.93 [95% CI 
      1.79-2.09], p<0.0001) and hospital admissions (1.33 [1.27-1.38], p<0.0001) in 
      children 5 years or younger. No differences in household income were observed 
      between the exposed and unexposed cohorts. INTERPRETATION: iGBS disease, 
      especially meningitis, was associated with increased mortality and a higher risk 
      of NDIs in later childhood. This previously unquantified burden underlines the 
      case for a maternal GBS vaccine, and the need to track and provide care for 
      affected survivors of iGBS disease. FUNDING: The Bill & Melinda Gates Foundation. 
      TRANSLATIONS: For the Dutch and Danish translations of the abstract see 
      Supplementary Materials section.
CI  - Copyright (c) 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access 
      article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights 
      reserved.
FAU - Horvath-Puho, Erzsebet
AU  - Horvath-Puho E
AD  - Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark.
FAU - van Kassel, Merel N
AU  - van Kassel MN
AD  - Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of 
      Amsterdam, Amsterdam, Netherlands.
FAU - Goncalves, Bronner P
AU  - Goncalves BP
AD  - Maternal, Adolescent, Reproductive & Child Health Centre and Department of 
      Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, 
      London, UK.
FAU - de Gier, Brechje
AU  - de Gier B
AD  - Centre for Infectious Disease Control, National Institute for Public Health and 
      the Environment, Bilthoven, Netherlands.
FAU - Procter, Simon R
AU  - Procter SR
AD  - Maternal, Adolescent, Reproductive & Child Health Centre and Department of 
      Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, 
      London, UK.
FAU - Paul, Proma
AU  - Paul P
AD  - Maternal, Adolescent, Reproductive & Child Health Centre and Department of 
      Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, 
      London, UK.
FAU - van der Ende, Arie
AU  - van der Ende A
AD  - Netherlands Reference Laboratory for Bacterial Meningitis, Amsterdam UMC, 
      University of Amsterdam, Amsterdam, Netherlands; The National Institute for 
      Public Health and the Environment, University of Amsterdam, Amsterdam, 
      Netherlands; Department of Medical Microbiology and Infection Prevention, 
      Amsterdam Infection and Immunity, Amsterdam, Netherlands.
FAU - Sogaard, Kirstine K
AU  - Sogaard KK
AD  - Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark; 
      Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, 
      Denmark.
FAU - Hahne, Susan J M
AU  - Hahne SJM
AD  - Centre for Infectious Disease Control, National Institute for Public Health and 
      the Environment, Bilthoven, Netherlands.
FAU - Chandna, Jaya
AU  - Chandna J
AD  - Maternal, Adolescent, Reproductive & Child Health Centre and Department of 
      Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, 
      London, UK.
FAU - Schrag, Stephanie J
AU  - Schrag SJ
AD  - Division of Bacterial Diseases, Centers for Disease Control and Prevention, 
      Atlanta, GA, USA.
FAU - van de Beek, Diederik
AU  - van de Beek D
AD  - Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of 
      Amsterdam, Amsterdam, Netherlands.
FAU - Jit, Mark
AU  - Jit M
AD  - Maternal, Adolescent, Reproductive & Child Health Centre and Department of 
      Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, 
      London, UK.
FAU - Sorensen, Henrik T
AU  - Sorensen HT
AD  - Department of Clinical Epidemiology, Aarhus University, Aarhus N, Denmark.
FAU - Bijlsma, Merijn W
AU  - Bijlsma MW
AD  - Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of 
      Amsterdam, Amsterdam, Netherlands; Department of Paediatrics, Amsterdam UMC, 
      University of Amsterdam, Amsterdam, Netherlands.
FAU - Lawn, Joy E
AU  - Lawn JE
AD  - Maternal, Adolescent, Reproductive & Child Health Centre and Department of 
      Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, 
      London, UK. Electronic address: joy.lawn@lshtm.ac.uk.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210421
PL  - England
TA  - Lancet Child Adolesc Health
JT  - The Lancet. Child & adolescent health
JID - 101712925
SB  - IM
CIN - Lancet Child Adolesc Health. 2021 Jun;5(6):386-387. PMID: 33894158
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Cohort Studies
MH  - Cost of Illness
MH  - Denmark/epidemiology
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Meningitis/diagnosis/epidemiology/etiology/mortality
MH  - Mortality/trends
MH  - Netherlands/epidemiology
MH  - Neurodevelopmental Disorders/epidemiology/*etiology
MH  - Perinatal Death/*prevention & control
MH  - Pneumonia/diagnosis/epidemiology/etiology/mortality
MH  - Sepsis/diagnosis/epidemiology/etiology/mortality
MH  - Severity of Illness Index
MH  - Streptococcal Infections/*complications/diagnosis/epidemiology/*mortality
MH  - Streptococcus agalactiae/isolation & purification
PMC - PMC8131199
COIS- Declaration of interests AvdE received grants from Pfizer for research on 
      pneumococcal infections (investigator initiated project IIR WI173197) and for 
      research on meningococcal infections (investigator initiated project IIR 
      WI242174), outside the submitted work; participated in the Advisory Boards of 
      Pfizer, GlaxoSmithKline, and Sanofi-Pasteur; and did consultancy activities for 
      GlaxoSmithKline and Merck Sharp & Dohme (fees paid to Amsterdam University 
      Medical Center). HTS reports that the Department of Clinical Epidemiology is 
      involved in studies with institutional funding from regulators and from various 
      pharmaceutical companies, as research grants to and administered by Aarhus 
      University. None of these studies are related to the current study. All other 
      authors declare no competing interests.
EDAT- 2021/04/25 06:00
MHDA- 2021/07/27 06:00
PMCR- 2021/06/01
CRDT- 2021/04/24 20:07
PHST- 2020/10/28 00:00 [received]
PHST- 2021/01/04 00:00 [revised]
PHST- 2021/01/08 00:00 [accepted]
PHST- 2021/04/25 06:00 [pubmed]
PHST- 2021/07/27 06:00 [medline]
PHST- 2021/04/24 20:07 [entrez]
PHST- 2021/06/01 00:00 [pmc-release]
AID - S2352-4642(21)00022-5 [pii]
AID - 10.1016/S2352-4642(21)00022-5 [doi]
PST - ppublish
SO  - Lancet Child Adolesc Health. 2021 Jun;5(6):398-407. doi: 
      10.1016/S2352-4642(21)00022-5. Epub 2021 Apr 21.