ABSTRACT 613

Abstract

Background and aims: Late-onset infection is known to increase the risk of neurodevelopmental impairment in infants born extremely preterm. However, little data is available regarding infants born moderately preterm. Aims: Our objectives were to determine (1) the risk of late-onset infection according to gestational age and birthweight, and (2) if late-onset infection is associated with neurodevelopmental impairment at two years of corrected age. Methods: This study included all surviving infants born between January 2003 and December 2009 at <35 weeks of gestational age, and enrolled for follow-up in the regional “Loire Infant Follow-up Team” (LIFT) network (France). Neurodevelopmental outcome was evaluated at two years of corrected age. Odds ratio were adjusted for gestational age, birthweight Z-score and a propensity score. Results: 5.326 preterm infants born <35 weeks of gestation were enrolled in this study and 688 infants acquired late-onset infection (12.9%). The risk of late-onset infection increased exponentially up to 24 weeks of gestational age (aOR=266; 95% CI: 106–670; p=0.001). In parallel, a birthweight Z-score <0 was associated with a significant increase in the risk of late-onset infection (aOR= 1.4; 95% CI: 1.02–1.91; p=0.036) (Figure).FigureLate-onset infection was associated with non-optimal neurodevelopmental outcome at two years (OR, 2.5; 95% CI: 2.1–3.0; p=0.001). Moreover, this correlation persisted after adjusting for gestational age and birthweight Z-score (aOR=1.4; 95% CI: 1.1–1.8; p=0.003), as well as for propensity score (aOR, 1.4; 95% CI: 1.1–1.8; p=0.009). Conclusions: Late-onset infection is associated with non-optimal neurodevelopmental outcome at two years of corrected age after adjusting for gestational age and birthweight Z-score as well as for propensity score.