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

BackgroundGroup 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 this study was to assess mortality, neurodevelopmental impairments (NDIs), and economic outcomes infant invasive GBS (iGBS) up adolescence in Denmark the Netherlands.MethodsFor cohort study, children with iGBS were identified Netherlands using national medical administrative databases culture results that confirmed their diagnoses. Exposed defined as having history (sepsis, meningitis, or pneumonia) by age 89 days. For each exposed child, ten unexposed randomly selected matched sex, year month birth, gestational age. Mortality data analysed use Cox proportional hazards models. NDI captured from discharge diagnoses National Patient Registry (Denmark) special educational support records (the Netherlands). Health care household income also compared between cohorts.Findings2258 children—1561 (born Jan 1, 1997 Dec 31, 2017) 697 2000 2017)—were followed for median 14 years (IQR 7–18) 9 (6–11) Netherlands. 366 had 1763 sepsis, 129 pneumonia (in only). These 22 462 no disease. meningitis associated an increased mortality at 5 (adjusted hazard ratio 4·08 [95% CI 1·78–9·35] 6·73 [3·76–12·06] Any risk 10 age, both (risk 1·77 1·44–2·18]) (2·28 [1·64–3·17]). A more frequent outpatient clinic visits (incidence rate 1·93 1·79–2·09], p<0·0001) hospital admissions (1·33 [1·27–1·38], younger. No differences observed cohorts.InterpretationiGBS disease, especially higher NDIs later This previously unquantified burden underlines case maternal vaccine, need track provide affected survivors disease.FundingThe Bill & Melinda Gates Foundation.TranslationsFor Dutch Danish translations abstract see Supplementary Materials section. Group cohorts. 2258