Clinical Risk Factors Associated With Late-Onset Invasive Group B Streptococcal Disease: Systematic Review and Meta-Analyses.

Konstantinos Karampatsas ORCID logo ; Hannah Davies ORCID logo ; Maren Mynarek ; Nick Andrews ; Paul T Heath ; Kirsty Le Doare ; (2022) Clinical Risk Factors Associated With Late-Onset Invasive Group B Streptococcal Disease: Systematic Review and Meta-Analyses. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 75 (7). pp. 1255-1264. ISSN 1058-4838 DOI: 10.1093/cid/ciac206
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BACKGROUND: Group B streptococcal (GBS) infection remains one of the most significant causes of late-onset sepsis and meningitis (LOGBS) among young infants. However, transmission routes and risk factors for LOGBS are not yet fully understood. METHODS: We conducted systematic reviews on clinical risk factors previously reported in the literature (prematurity, low birth weight [<2500 g], antenatal colonization, multiple-gestation pregnancy, maternal age <20 years, male infant sex, intrapartum fever, prolonged rupture of membranes) and meta-analyses to determine pooled estimates of risk. RESULTS: We included 27 articles, reporting 5315 cases. Prematurity (odds ratio [OR] 5.66; 95% confidence interval [CI]: 4.43-7.22), low birth weight (OR 6.73; 95% CI: 4.68-9.67), maternal colonization (2.67; [2.07-3.45]), and multiple-gestation pregnancies (OR 8.01; 95% CI: 5.19-12.38) were associated with an increased risk of LOGBS. CONCLUSIONS: Prematurity/low birth weight and maternal colonization are major risk factors for LOGBS. Future GBS vaccine studies should try to establish the optimal time for vaccination during pregnancy to protect preterm infants.

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