@article{0a60d8c893b8482e897bb70eb63b32d2,
title = "Neonatal Encephalopathy with Group B Streptococcal Disease Worldwide: Systematic Review, Investigator Group Datasets, and Meta-analysis",
abstract = "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Sciences Literature [LILACS], World Health Organization Library Information System [WHOLIS], and Scopus) and sought unpublished data from investigator groups reporting GBS-associated NE.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 Four published and 25 unpublished datasets were identified from 13 countries (N = 10 436). 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- A nd middle-resource contexts.",
keywords = "Group B Streptococcus, hypoxic-ischemic encephalopathy, neonatal encephalopathy, newborn, therapeutic hypothermia.",
author = "Tann, {Cally J.} and Martinello, {Kathryn A.} and Samantha Sadoo and Lawn, {Joy E.} and Seale, {Anna C.} and Maira Vega-Poblete and Russell, {Neal J.} and Baker, {Carol J.} and Linda Bartlett and Clare Cutland and Gravett, {Michael G.} and Margaret Ip and {Le Doare}, Kirsty and Madhi, {Shabir A.} and Rubens, {Craig E.} and Saha, {Samir K.} and Stephanie Schrag and {Sobanjo-Ter Meulen}, Ajoke and Johan Vekemans and Heath, {Paul T.}",
note = "Funding Information: Supplement sponsorship. This article appears as part of the supplement “The Burden of Group B Streptococcus Worldwide for Pregnant Women, Stillbirths, and Children,” sponsored by the Bill & Melinda Gates Foundation and coordinated by the London School of Hygiene & Tropical Medicine. Funding Information: 1Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene & Tropical Medicine, United Kingdom; 2Neonatal Medicine, University College London Hospitals NHS Foundation Trust, United Kingdom; 3Institute for Women{\textquoteright}s Health, University College London, United Kingdom; 4College of Health and Medical Sciences, Haramaya University, Dire Dawa, Ethiopia; 5Medical School, University College London, United Kingdom; 6King{\textquoteright}s College London, United Kingdom; 7Departments of Pediatrics and Molecular Virology and Microbiology, Baylor College of Medicine, Houston, Texas; 8Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 9Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, and Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; 10Global Alliance to Prevent Prematurity and Stillbirth, Seattle, Washington; 11Department of Obstetrics and Gynecology, University of Washington, Seattle; 12Department of Microbiology, Faculty of Medicine, Chinese University of Hong Kong; 13Centre for International Child Health, Imperial College London, United Kingdom; 14Vaccine Institute, Institute for Infection and Immunity, St George{\textquoteright}s Hospital, University of London and St George{\textquoteright}s University Hospitals NHS Foundation Trust, United Kingdom; 15National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; 16Department of Global Health, University of Washington, Seattle; 17Bangladesh Institute of Child Health, Dhaka; 18National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; 19Bill & Melinda Gates Foundation, Seattle, Washington; and 20World Health Organization, Geneva, Switzerland Funding Information: Disclaimer. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of any of the agencies or organizations listed. Electronic patient data recorded at participating neonatal units that collectively form the United Kingdom Neonatal Collaborative are transmitted to the Neonatal Data Analysis Unit to form the NNRD. Financial support. This supplement was supported by a grant to the London School of Hygiene & Tropical Medicine from the Bill & Melinda Gates Foundation (Grant ID: OPP1131158). Funding Information: Potential conflicts of interest. Many contributors to this supplement have received funding for their research from foundations, especially the Bill & Melinda Gates Foundation, and several from the Wellcome Trust, the Medical Research Council UK, the Thrasher Foundation, the Meningitis Research Foundation, and one individual from the US National Institutes of Health. Members of the Expert Advisory Group received reimbursement for travel expenses to attend working meetings related to this series. A. S.-t. M. works for the Bill & Melinda Gates Foundation. C. J. B. has served as a member of the Presidential Advisory Committee for Seqirus Inc and of the CureVac Inc Scientific Advisory Committee, as well as undertaken consultancy work for Pfizer Inc. C. C. has received institutional compensation from Novartis for conducting GBS studies. P. T. H. has been a consultant to Novartis and Pfizer on GBS vaccines but received no funding for these activities. M. I. has undertaken sponsored research from Pfizer on pneumococcal disease in adults and from Belpharma Eumedica (Belgium) on temocillin antimicrobial susceptibility in Enterobacteriaceae. K. L. D. has received funding by the Bill & Melinda Gates Foundation to work on research on GBS serocorrelates of protection to inform vaccine trials, and travel expenses from Pfizer to attend a meeting on an investigator-led project on GBS. S. A. M. has collaborated on GBS grants funded by GlaxoSmithKline and by Pfizer and received personal fees for being member of its advisory committee; he has also collaborated on a GBS grant funded by Minervax. L. D. V. has received a grant from ZonMW. K. M. and N. J. R. collaborated in 2016 on a project in which Chiesi Pharmaceutical partly funded and supplied melatonin. All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Publisher Copyright: {\textcopyright} 2017 The Author.",
year = "2017",
doi = "10.1093/cid/cix662",
language = "English (US)",
volume = "65",
pages = "S173--S189",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
}