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Neonatal infections increased cerebral palsy risk
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Very preterm infants with neonatal infections had an increased risk for cerebral palsy at aged 5 years, particularly those presenting with early- and late-onset sepsis, according to recent study findings.
“Neonatal infections are frequent complications in very preterm infants, already at high risk of neurologic and cognitive disabilities,” Ayoub Mitha, MD, and colleagues in France wrote in a study published in Pediatrics. “Few studies have linked neonatal infections and neurodevelopmental outcomes. Those that did evaluated children only to the age of 22 months.”
The study included 2,665 live births between 22 and 32 weeks of gestation.
Researchers found that 5% of participants included in the studies presented with early-onset sepsis only, 28% with late-onset sepsis only, and 2% with both early-onset sepsis and late-onset sepsis. At the 5-year follow-up, cerebral palsy presented in 9% (157 of 1,769) and 12% (177 of 1,495) presented with cognitive impairment. Cerebral palsy occurred more often in participants with isolated early-onset sepsis (OR=1.70; 95% CI, 0.84-3.45) or isolated late-onset sepsis (OR=1.71; 95% CI, 1.14-2.56). The risk was even higher in participants with both early-onset sepsis and late-onset sepsis (OR=2.33; 95% CI, 1.02-5.33). Researchers did not find an association between neonatal infection and cognitive impairment.
“The originality of the current study resides in the use of an indicator combining the two types of neonatal infections in relation to cerebral palsy and cognitive impairment at 5 years of age,” researchers wrote. “The higher risk of cerebral palsy in cases of neonatal infection is consistent with the neurotoxic effects of infectious and inflammatory mediators on cerebral white matter, particularly in children suffering both early- and late-onset infections. The development of appropriate strategies for reducing infection rates would thus help to improve the neurodevelopment outcomes of these vulnerable infants.”
Disclosure: The study was funded in part by the French National Institutes of Health and Medical Research, Directorate General for Health of the Ministry for Social Affairs, and Hospital Program for Clinical Research 2001.
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