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Infections among very preterm infants linked to impaired neurodevelopment
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Infections among very preterm neonates increased the risks for neurodevelopmental impairment, including IQ delays, motor impairment and attention-deficit/hyperactivity disorder, according to recent research in The Journal of Pediatrics.
“This study examined the impact of neonatal infection on a broad range of longer-term outcomes in a cohort of very preterm infants,” Lianne J. Woodward, PhD, of the department of pediatric newborn medicine at Brigham and Women’s Hospital, and colleagues wrote. “Confirmed neonatal infection heightens very preterm infants’ risk for neurodevelopmental impairment.”
The researchers studied a cohort of 110 infants born at or before 32 weeks gestation in New Zealand, from birth to aged 9 years. Patients were monitored for confirmed neonatal infections, classified as any infection with positive blood, cerebrospinal fluid or urine cultures, or stage 2 or higher necrotizing enterocolitis. Patients also were monitored for suspected neonatal infections, requiring any use of antibiotics for 5 or more days. The researchers performed imaging on participants during infancy and tested them at age 9 years for neuromotor function, IQ, educational achievement and mental health.
Data showed that 25% of participants had confirmed infection, while 23% had a suspected infection. Among the patients with infections, more than half had multiple suspected or confirmed infections. Children with confirmed infections were more likely to have neurodevelopmental impairments compared with uninfected children (RR = 1.4-3.1). Specifically, children with confirmed infections were at an increased risk for severe motor impairment (OR = 3.3; 95% CI, 1.3-8), ADHD (OR = 3.6; 95% CI, 1.6-8) and IQ delay (OR = 2; 95% CI, 1-3.9).
The researchers wrote that white matter abnormalities correlated with confirmed infections linked to motor impairment and IQ delays, but not ADHD (P = .005).
“White matter abnormality was shown to act as an intervening factor in the pathway from neonatal infection to both motor and cognitive delay but did not contribute significantly to observed attention deficits,” Woodward and colleagues wrote. “Further analysis of the neurologic mechanism accounting for ADHD in infants with infection is needed.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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