TY - JOUR
T1 - Stillbirth with Group B Streptococcus Disease Worldwide
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.
N1 - Funding Information:
Financial support. This work 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, including the Bill & Melinda Gates Foundation, Wellcome Trust, Medical Research Council UK, Thrasher Foundation, Meningitis Research Foundation, and 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. 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:
© 2017 The Author.
PY - 2017
Y1 - 2017
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.
AB - 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.
KW - estimates
KW - group B Streptococcus
KW - mortality
KW - stillbirth
KW - stillborn
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U2 - 10.1093/cid/cix585
DO - 10.1093/cid/cix585
M3 - Review article
C2 - 29117322
AN - SCOPUS:85034214839
SN - 1058-4838
VL - 65
SP - S125-S132
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
ER -