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.
Meningitis and Special Pathogens Branch Center for Infectious Diseases, Atlanta, GA 30333.
A
A
Schuchat
M
M
Oxtoby
S
S
Cochi
R K
RK
Sikes
A
A
Hightower
B
B
Plikaytis
C V
CV
Broome
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