Abstract
AimsThe study investigated a putative association between early-onset-sepsis (EOS) and poor neurodevelopmental outcomes at 2 years corrected age in very low birth weight infants.MethodsThis was a single-center cohort study on infants weighing less than 1500 g with a gestational age below 35 weeks at birth born between 2008 and 2011. Neurodevelopmental outcomes were assessed at follow-up with the Bayley Scales of Infant Development-II. EOS was defined as either culture-proven EOS or clinical EOS using blood culture, CrP levels, and clinical symptoms and treatment. Neurodevelopmental impairment (NDI) was defined as one or more of the following: Mental Developmental Index (MDI) and/or Psychomotor Developmental Index (PDI) scores lower than 70; presence of cerebral palsy.ResultsOf 405 eligible newborns in the study period 166 were included. Two had culture-proven and 29 clinical EOS. Median MDI scores in patients with EOS were 96 (IQR: 86–106) and in the control group 94 (84–106, p = 0.77). PDI scores in patients with EOS were 96 (86–106) and in the control group 99,5 (92–103, p = 0.03). Of infected patients 7/31 (24%) showed NDI as defined, whereas only 11/135 (8%) showed NDI in the control group (OR 3.3, p = 0.03). Multiple regression analyses identified chorioamnionitis and poor CRIB-Scores as individual risk factors for MDI or PDI values < 70.ConclusionIn our study, EOS among VLBW-infants significantly impaired the neurodevelopment at 2 years corrected age. As shown in previous reports infection continues to be a problem and strategies for a reduction need further improvement.
Highlights
Very low birth weight infants (VLBW, birth weight < 1500 g) are more susceptible to brain injury than term infants
Study population Altogether 405 VLBW infants were born in the study period
Our findings support the hypothesis that VLBWinfants with EOS in our study cohort had an increased risk for poor neurodevelopmental outcomes at 2 years of age
Summary
Very low birth weight infants (VLBW, birth weight < 1500 g) are more susceptible to brain injury than term infants. This may lead to adverse long-term neurodevelopmental outcomes [1, 2]. While survival rates of VLBW-infants have increased in recent years, the rates. Saigal et al [2] pointed out that about one quarter of surviving preterm infants have substantial neurological morbidity. Several mechanisms have been proposed as to how systemic inflammation and subsequently elevated cytokine levels in mother and child in the perinatal period may damage brain parenchyma [5,6,7].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
