Abstract
Background: Male infants have a higher incidence of invasive group B Streptococcus disease (iGBS) compared with female infants; however, data on sex differences in mortality and long-term outcomes after iGBS are lacking. We assessed whether a child's sex influences the effects of iGBS on mortality and risk of neurodevelopmental impairments (NDIs). Methods: We used Danish and Dutch registry data to conduct a nationwide cohort study of infants with a history of iGBS. A comparison cohort, children without a history of iGBS, was randomly selected and matched on relevant factors. Effect modification by sex was assessed on additive and multiplicative scales. Results: Our analyses included data from children with a history of iGBS in Denmark (period 1997 -2017; n = 1432) and the Netherlands (2000 -2017; n = 697) and from 21 172 children without iGBS. There was no clear evidence of between-sex heterogeneity in iGBS-associated mortality. Boys had a higher risk of NDI, with evidence for effect modification on additive scale at the age of 5 years for any NDI (relative excess risk due to interaction = 1.28; 95% confidence interval [CI], -0.53 to 3.09 in Denmark and 1.14; 95% CI, -5.13 to 7.41 in the Netherlands). A similar pattern was observed for moderate/severe NDI at age 5 years in Denmark and age 10 years in the Netherlands. Conclusion: Boys are at higher risk of NDI; our results suggest this is disproportionally increased in those who develop iGBS. Future studies should investigate mechanisms of this effect modification by sex.
Original language | English |
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Journal | Clinical Infectious Diseases |
Volume | 74 |
Issue number | Suppl. 1 |
Pages (from-to) | S54-S63 |
ISSN | 1058-4838 |
DOIs | |
Publication status | Published - 15 Jan 2022 |
Bibliographical note
© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.Keywords
- effect modification
- group B Streptococcus
- neurodevelopmental impairments
- sex differences
- Streptococcus agalactiae
- Humans
- Risk Factors
- Child, Preschool
- Infant
- Male
- Streptococcal Infections/epidemiology
- Sex Characteristics
- Denmark/epidemiology
- Infant, Premature
- Female
- Netherlands/epidemiology
- Child
- Infant, Newborn
- Cohort Studies