Neurological Manifestations and Complications of Neonatal Meningitis: A Systematic Review and Meta-analysis

Abstract

Background: Neonatal meningitis has significant worldwide morbidity and mortality rates. Nevertheless, the clinical manifestations of neonatal meningitis are subtle and nonspecific which can pose challenges in terms of timely diagnosis and intervention. This meta-analysis aims to the prevalence of neurological manifestations and complications associated with neonatal meningitis in term and preterm neonates. Methods: A systematic literature search was conducted in PubMed, SCOPUS, and Ovid SP to identify relevant studies. Pooled prevalence of neurological manifestations and complications with a 95% confidence interval (CI) were calculated using the random-effects generic inverse variance model. Statistical analysis was performed using Review Manager v5.4 and R programming. Results: A total of 25 studies with 2252 patients evaluated for neurological symptoms and 1822 patients evaluated for neurological complications were included in this meta-analysis. The overall prevalence of neurological manifestations in neonatal meningitis was 23% (95% CI, 20% to 26%). The overall prevalence of neurological complications in neonatal meningitis was 8% (95% CI, 6% to 9%). Conclusion: Our meta-analysis revealed a low prevalence of neurological manifestations and complications in neonatal meningitis. Although neurological complications occur less frequently, the complications are significantly associated with higher mortality and morbidity rates.