Population-based risk factors for neonatal group B streptococcal disease: results of a cohort study in metropolitan Atlanta.
To determine risk factors for neonatal group B streptococcal (GBS) disease, a cohort study was conducted in Atlanta of infants with invasive GBS disease during 1982 and 1983. Laboratory review detected 71 infants with early-onset disease (1.09 cases/1000 live births) and 37 infants with late-onset disease (0.57 cases/1000 live births). Compared with the 64,858 births in Atlanta in the same period, infants with early-onset GBS disease were more often black, less than 2500 g, and born to teenage mothers. A history of miscarriage increased a woman's risk of delivering an infant with early-onset disease. Black infants had 35 times the risk of late-onset disease that nonblack infants had. Thirty percent of early-onset disease and 92% of late-onset disease could be attributed to black race, independent of other risk factors. Most case-mothers (96%) received prenatal care, suggesting that prevention strategies such as prenatal screening or maternal immunization could reach nearly all the population at risk.
Schuchat
A
A
Meningitis and Special Pathogens Branch Center for Infectious Diseases, Atlanta, GA 30333.
Oxtoby
M
M
Cochi
S
S
Sikes
R K
RK
Hightower
A
A
Plikaytis
B
B
Broome
C V
CV
D000022:Abortion, Spontaneous; D001741:Black or African American; D001724:Birth Weight; D015331:Cohort Studies; D005260:Female; D005845:Georgia / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D008423:Maternal Age; D015999:Multivariate Analysis; D010298:Parity; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013290:Streptococcal Infections / Q000453:epidemiology*; D013292:Streptococcus agalactiae