Stillbirth with Group B Streptococcus Disease Worldwide: Systematic Review and Meta-analyses

Anna C. Seale, Hannah Blencowe, Fiorella Bianchi-Jassir, Nicholas Embleton, Quique Bassat, Jaume Ordi, Clara MenCrossed, Clare Cutland, Carmen Briner, James A. Berkley, Joy E. Lawn, Carol J. Baker, Linda Bartlett, Michael G. Gravett, Paul T. Heath, Margaret Ip, Kirsty Le Doare, Craig E. Rubens, Samir K. Saha, Stephanie SchragAjoke Sobanjo Ter Meulen, Johan Vekemans, Shabir A. Madhi

Research output: Contribution to journalReview article

Abstract

Background. There are an estimated 2.6 million stillbirths each year, many of which are due to infections, especially in low-and middle-income contexts. This paper, the eighth in a series on the burden of group B streptococcal (GBS) disease, aims to estimate the percentage of stillbirths associated with GBS disease. Methods. We conducted systematic literature reviews (PubMed/Medline, Embase, Literatura Latino-Americana e do Caribe em Ciencias da Saude, World Health Organization Library Information System, and Scopus) and sought unpublished data from investigator groups. Studies were included if they reported original data on stillbirths (predominantly.28 weeks'f gestation or.1000 g, with GBS isolated from a sterile site) as a percentage of total stillbirths. We did meta-analyses to derive pooled estimates of the percentage of GBS-associated stillbirths, regionally and worldwide for recent datasets. Results. We included 14 studies from any period, 5 with recent data (after 2000). There were no data from Asia. We estimated that 1% (95% confidence interval [CI], 0.2%) of all stillbirths in developed countries and 4% (95% CI, 2%.6%) in Africa were associated with GBS. Conclusions. GBS is likely an important cause of stillbirth, especially in Africa. However, data are limited in terms of geographic spread, with no data from Asia, and cases worldwide are probably underestimated due to incomplete case ascertainment. More data, using standardized, systematic methods, are critical, particularly from low-and middle-income contexts where the highest burden of stillbirths occurs. These data are essential to inform interventions, such as maternal GBS vaccination.

Original languageEnglish (US)
Pages (from-to)S125-S132
JournalClinical Infectious Diseases
Volume65
DOIs
StatePublished - Jan 1 2017
Externally publishedYes

Fingerprint

Streptococcus agalactiae
Stillbirth
Meta-Analysis
Confidence Intervals
Hispanic Americans
Developed Countries
PubMed
Information Systems
Libraries
Vaccination
Mothers
Research Personnel
Pregnancy
Infection

Keywords

  • estimates
  • group B Streptococcus
  • mortality
  • stillbirth
  • stillborn

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Seale, A. C., Blencowe, H., Bianchi-Jassir, F., Embleton, N., Bassat, Q., Ordi, J., ... Madhi, S. A. (2017). Stillbirth with Group B Streptococcus Disease Worldwide: Systematic Review and Meta-analyses. Clinical Infectious Diseases, 65, S125-S132. https://doi.org/10.1093/cid/cix585

Stillbirth with Group B Streptococcus Disease Worldwide : Systematic Review and Meta-analyses. / Seale, Anna C.; Blencowe, Hannah; Bianchi-Jassir, Fiorella; Embleton, Nicholas; Bassat, Quique; Ordi, Jaume; MenCrossed, Clara; Cutland, Clare; Briner, Carmen; Berkley, James A.; Lawn, Joy E.; Baker, Carol J.; Bartlett, Linda; Gravett, Michael G.; Heath, Paul T.; Ip, Margaret; Le Doare, Kirsty; Rubens, Craig E.; Saha, Samir K.; Schrag, Stephanie; Meulen, Ajoke Sobanjo Ter; Vekemans, Johan; Madhi, Shabir A.

In: Clinical Infectious Diseases, Vol. 65, 01.01.2017, p. S125-S132.

Research output: Contribution to journalReview article

Seale, AC, Blencowe, H, Bianchi-Jassir, F, Embleton, N, Bassat, Q, Ordi, J, MenCrossed, C, Cutland, C, Briner, C, Berkley, JA, Lawn, JE, Baker, CJ, Bartlett, L, Gravett, MG, Heath, PT, Ip, M, Le Doare, K, Rubens, CE, Saha, SK, Schrag, S, Meulen, AST, Vekemans, J & Madhi, SA 2017, 'Stillbirth with Group B Streptococcus Disease Worldwide: Systematic Review and Meta-analyses', Clinical Infectious Diseases, vol. 65, pp. S125-S132. https://doi.org/10.1093/cid/cix585
Seale AC, Blencowe H, Bianchi-Jassir F, Embleton N, Bassat Q, Ordi J et al. Stillbirth with Group B Streptococcus Disease Worldwide: Systematic Review and Meta-analyses. Clinical Infectious Diseases. 2017 Jan 1;65:S125-S132. https://doi.org/10.1093/cid/cix585
Seale, Anna C. ; Blencowe, Hannah ; Bianchi-Jassir, Fiorella ; Embleton, Nicholas ; Bassat, Quique ; Ordi, Jaume ; MenCrossed, Clara ; Cutland, Clare ; Briner, Carmen ; Berkley, James A. ; Lawn, Joy E. ; Baker, Carol J. ; Bartlett, Linda ; Gravett, Michael G. ; Heath, Paul T. ; Ip, Margaret ; Le Doare, Kirsty ; Rubens, Craig E. ; Saha, Samir K. ; Schrag, Stephanie ; Meulen, Ajoke Sobanjo Ter ; Vekemans, Johan ; Madhi, Shabir A. / Stillbirth with Group B Streptococcus Disease Worldwide : Systematic Review and Meta-analyses. In: Clinical Infectious Diseases. 2017 ; Vol. 65. pp. S125-S132.
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T2 - Systematic Review and Meta-analyses

AU - Seale, Anna C.

AU - Blencowe, Hannah

AU - Bianchi-Jassir, Fiorella

AU - Embleton, Nicholas

AU - Bassat, Quique

AU - Ordi, Jaume

AU - MenCrossed, Clara

AU - Cutland, Clare

AU - Briner, Carmen

AU - Berkley, James A.

AU - Lawn, Joy E.

AU - Baker, Carol J.

AU - Bartlett, Linda

AU - Gravett, Michael G.

AU - Heath, Paul T.

AU - Ip, Margaret

AU - Le Doare, Kirsty

AU - Rubens, Craig E.

AU - Saha, Samir K.

AU - Schrag, Stephanie

AU - Meulen, Ajoke Sobanjo Ter

AU - Vekemans, Johan

AU - Madhi, Shabir A.

PY - 2017/1/1

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N2 - Background. There are an estimated 2.6 million stillbirths each year, many of which are due to infections, especially in low-and middle-income contexts. This paper, the eighth in a series on the burden of group B streptococcal (GBS) disease, aims to estimate the percentage of stillbirths associated with GBS disease. Methods. We conducted systematic literature reviews (PubMed/Medline, Embase, Literatura Latino-Americana e do Caribe em Ciencias da Saude, World Health Organization Library Information System, and Scopus) and sought unpublished data from investigator groups. Studies were included if they reported original data on stillbirths (predominantly.28 weeks'f gestation or.1000 g, with GBS isolated from a sterile site) as a percentage of total stillbirths. We did meta-analyses to derive pooled estimates of the percentage of GBS-associated stillbirths, regionally and worldwide for recent datasets. Results. We included 14 studies from any period, 5 with recent data (after 2000). There were no data from Asia. We estimated that 1% (95% confidence interval [CI], 0.2%) of all stillbirths in developed countries and 4% (95% CI, 2%.6%) in Africa were associated with GBS. Conclusions. GBS is likely an important cause of stillbirth, especially in Africa. However, data are limited in terms of geographic spread, with no data from Asia, and cases worldwide are probably underestimated due to incomplete case ascertainment. More data, using standardized, systematic methods, are critical, particularly from low-and middle-income contexts where the highest burden of stillbirths occurs. These data are essential to inform interventions, such as maternal GBS vaccination.

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