婴儿期B群链球菌疾病和幼儿随后神经发育障碍的风险：加拿大安大略省一项基于人群的队列研究

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES

Lancet Regional Health-Americas Pub Date : 2025-07-02 DOI:10.1016/j.lana.2025.101170

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

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引用次数: 0

摘要

背景B群链球菌（GBS）是全球新生儿发病和死亡的主要感染性原因，但关于儿童长期结局的数据仍然有限。我们的目的是评估GBS幸存者神经发育障碍（ndi）的风险，并探讨性别和早产对影响的影响。方法：我们对2012年4月至2018年3月期间安大略省的活产婴儿进行了一项基于人群的队列研究，使用了相关的出生登记、实验室和卫生管理数据库。通过培养结果和诊断代码确定出生第一年的GBS疾病。ndi包括认知、运动、感觉（听觉、视觉）和社会/行为领域，使用诊断代码确定到5岁。使用Cox回归来估计总体、特定区域和多区域ndi的校正风险比（aHR），比较婴儿期有无GBS疾病的儿童。结果：764934例婴儿中，771例有GBS病史。GBS幸存者发生任何NDI的风险增加了两倍（校正风险比[aHR]: 2.18 [95% CI: 1.88, 2.54]），认知（aHR: 2.79 [95% CI: 2.37, 3.30]）、运动（aHR: 7.08 [95% CI: 2.93, 17.08]）、社会/行为（aHR: 1.60 [95% CI: 1.20, 2.14]）和感觉（aHR: 1.64 [95% CI: 1.02, 2.64]）损伤的发生率更高。男婴和早产儿（37周）发生gbs相关ndi的风险高得不成比例。婴儿期bs疾病与5岁时发生ndi的高风险相关，特别是对于男性儿童和早产儿。需要一级预防策略来减轻生命早期GBS疾病对发育的长期影响。资助加拿大卫生研究所。

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Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, Canada

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.

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来源期刊

Lancet Regional Health-Americas Multiple-

CiteScore

8.00

自引率

0.00%

发文量

期刊介绍： The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.