Volume 115, March 2026, Pages 57-63Author links open overlay panel, , , , AbstractObjectives

Better quantification of long-term neurodevelopmental impairments following invasive Group B Streptococcus disease (iGBS) in early infancy can inform prognostication and societal impacts, including children's educational and social care needs.

Study design

A population-based observational prevalence study.

Methods

Children born 1997–2010, who survived iGBS sepsis or meningitis within the first 89 days after birth and completed public school tests aged 8–15 years were matched 1:20 with a general population comparison group without iGBS by sex and year of birth in Denmark. IGBS was identified using the Danish National Patient Registry covering all Danish hospitals and International Classification of Diseases, Tenth Revision codes. Standardized school test scores from 2010 to 2019 were obtained from the Danish Ministry of Education. Adjusted differences (adj. diff.) in school performance and corresponding 95 % confidence intervals (CIs) were estimated by subject type, grade, sex (at birth), and preterm birth using multivariable linear regression models with robust variance estimators.

Results

Among 807 iGBS survivors (90.7 % sepsis, 9.3 % meningitis) and 16,140 comparators, iGBS-sepsis survivors' performance was comparable to children without iGBS across tests, subjects, or grades. However, iGBS-meningitis survivors performed poorer than their matched comparators (adj. diff. −2·74 [95 % CI −5·19; −0·29]). Preterm birth was associated with poorer performance, regardless of a history of iGBS. No difference in test scores was found between sexes.

Conclusion

Among Danish school children, no overall difference was observed in school performance between children with a history of iGBS and comparators. However, iGBS-meningitis and preterm birth were linked to lower standardized test scores. This association was not observed in children who had iGBS-sepsis, unless they were also preterm.

Abbreviations in order of appearanceIGBS

Invasive group B Streptococcus disease

NDI

Neurodevelopmental impairment

CRS

Danish Civil Registration System

DMBR

Danish Medical Birth Registry

DNPR

Danish National Patient Registry

ICD-10

International Classification of Diseases, Tenth Revision

STIL

Danish Board for IT and Learning “Styrelsen for IT og læring”

CCI

Charlson Comorbidity Index

ADJ. DIFF

Adjusted difference

Keywords

group b streptococcus

Streptococcus agalactiae

Neonate

epidemiology

School performance

cognitive impairment

© 2026 The Authors. Published by Elsevier Inc.