Group B Streptococcus disease during infancy and risk of subsequent neurodevelopmental impairments in young children: a population-based cohort study in Ontario, Canada
Bibliographic record
Abstract
Background: (GBS) is a leading infectious cause of neonatal morbidity and mortality worldwide, yet data on longer-term outcomes in children remain limited. We aimed to assess the risk of neurodevelopmental impairments (NDIs) in GBS survivors and to explore effect modification by sex and prematurity. Methods: We performed a population-based cohort study of liveborn infants in Ontario between April 2012 and March 2018, using linked birth registry, laboratory, and health administrative databases. GBS disease in the first year of life was ascertained through culture results and diagnostic codes. NDIs, encompassing cognitive, motor, sensory (hearing, vision), and social/behavioural domains, were ascertained up to five years of age using diagnostic codes. Cox regression was used to estimate adjusted hazard ratios (aHR) for overall, domain-specific, and multidomain NDIs, comparing children with and without GBS disease during infancy. Findings: Of 764,934 infants, 771 had a history of GBS disease. GBS survivors had a twofold increased risk of any NDI (adjusted hazard ratio [aHR]: 2.18 [95% CI: 1.88, 2.54]) and higher rates of cognitive (aHR: 2.79 [95% CI: 2.37, 3.30]), motor (aHR: 7.08 [95% CI: 2.93, 17.08]), social/behavioural (aHR: 1.60 [95% CI: 1.20, 2.14]), and sensory (aHR: 1.64 [95% CI: 1.02, 2.64]) impairments. Male children and those born preterm (<37 weeks) had disproportionately higher risks of GBS-associated NDIs. Interpretation: GBS disease in infancy is associated with a higher risk of NDIs by age five years, particularly for male children and those born preterm. Primary prevention strategies are needed to mitigate long-term developmental impacts of early-life GBS disease. Funding: Canadian Institutes of Health Research.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".