Neurodevelopmental impairment in preterm infants with late-onset infection: not only in extremely preterm infants

Abstract

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. The aim of this study was to determine whether late-onset infection in moderately preterm infants (<35weeks of gestation) was associated with a non-optimal neurodevelopmental outcome at 2years of age. We analyzed a regional, population-based cohort of infants (LIFT cohort) between January 2003 and December 2009, and we used a propensity score method to reduce bias. Among the 4,618 preterm infants assessed at 2years, 618 had acquired late-onset infection (13.4%), and 764 had a non-optimal outcome (16.5%). The rate of non-optimal outcomes was significantly higher in preterm infants with late-onset infection, irrespective of subgroups of gestational age and birth weight Z-score. After adjusting for the propensity score, the relationship between late-onset infection and non-optimal neurodevelopmental outcome at 2years among infants born before 35weeks of gestation remained significant (aOR = 1.3; 95% CI 1.01-1.7; p = .04). Late-onset infection is associated with poor neurological outcome at 2years of age among infants born moderately preterm before and after adjustment for the propensity score.