Impact of sepsis on neurodevelopmental outcome in a swiss national cohort of extremely premature infants

Schlapbach, Luregn J., Aebischer, Maude, Adams, Mark, Natalucci, Giancarlo, Bonhoeffer, Jan, Latzin, Philipp, Nelle, Mathias, Bucher, Hans Ulrich, Latal, Beatrice, Swiss Neonatal Network and Follow-Up Group, Zeilinger, G., Capone, A., Glanzmann, R., Weber, P., Steinlin, M., Grunt, S., Bar, W., Keller, E., Killer, Ch., Tolsa, J.-F., Bickle-Graz, M., Pfister, R.E., Huppi, P. S., Borradori-Tolsa, C., Berger, T. M., Schmitt-Mechelke, T., Malzacher, A., Micallef, J. P., Steiner, F. and Arlettaz Mieth, R. (2011) Impact of sepsis on neurodevelopmental outcome in a swiss national cohort of extremely premature infants. Pediatrics, 128 2: E348-E357. doi:10.1542/peds.2010-3338

Author Schlapbach, Luregn J.
Aebischer, Maude
Adams, Mark
Natalucci, Giancarlo
Bonhoeffer, Jan
Latzin, Philipp
Nelle, Mathias
Bucher, Hans Ulrich
Latal, Beatrice
Swiss Neonatal Network and Follow-Up Group
Zeilinger, G.
Capone, A.
Glanzmann, R.
Weber, P.
Steinlin, M.
Grunt, S.
Bar, W.
Keller, E.
Killer, Ch.
Tolsa, J.-F.
Bickle-Graz, M.
Pfister, R.E.
Huppi, P. S.
Borradori-Tolsa, C.
Berger, T. M.
Schmitt-Mechelke, T.
Malzacher, A.
Micallef, J. P.
Steiner, F.
Arlettaz Mieth, R.
Title Impact of sepsis on neurodevelopmental outcome in a swiss national cohort of extremely premature infants
Journal name Pediatrics   Check publisher's open access policy
ISSN 0031-4005
Publication date 2011
Sub-type Article (original research)
DOI 10.1542/peds.2010-3338
Open Access Status
Volume 128
Issue 2
Start page E348
End page E357
Total pages 10
Place of publication Elk Grove Village, IL, United States
Publisher American Academy of Pediatrics
Language eng
Subject 2735 Pediatrics, Perinatology, and Child Health
Formatted abstract
OBJECTIVE: Neonatal sepsis causes high mortality and morbidity in preterm infants, but less is known regarding the long-term outcome after sepsis. This study aimed to determine the impact of sepsis on neurodevelopment at 2 years' corrected age in extremely preterm infants.

PATIENTS AND METHODS: This was a multicenter Swiss cohort study on infants born between 2000 and 2007 at 24 0/7 to 27 6/7 weeks' gestational age. Neurodevelopmental outcome was assessed with the Bayley Scales of Infant Development - II. Neurodevelopmental impairment (NDI) was defined as a Mental or Psychomotor Developmental Index lower than 70, cerebral palsy (CP), or visual or auditory impairment.

RESULTS: Of 541 infants, 136 (25%) had proven sepsis, 169 (31%) had suspected sepsis, and 236 (44%) had no signs of infection. CP occurred in 14 of 136 (10%) infants with proven sepsis compared with 10 of 236 (4%) uninfected infants (odds ratio [OR]: 2.90 [95% confidence interval (CI): 1.22-6.89]; P=.016). NDI occurred in 46 of 134 (34%) infants with proven sepsis compared with 55 of 235 (23%) uninfected infants (OR: 1.85 [95% CI: 1.12-3.05]; P = .016). Multivariable analysis confirmed that proven sepsis independently increased the risk of CP (OR: 3.23 [95% CI: 1.23-8.48]; P=.017) and NDI (OR: 1.69 [95% CI: 0.96-2.98]; P=.067). In contrast, suspected sepsis was not associated with neurodevelopmental outcome (P > .05). The presence of bronchopulmonary dysplasia, pathologic brain ultrasonography, retinopathy, and sepsis predicted the risk of NDI (P < .0001).

CONCLUSIONS: Proven sepsis significantly contributes to NDI in extremely preterm infants, independent of other risk factors. Better strategies aimed at reducing the incidence of sepsis in this highly vulnerable population are needed. 
Keyword Cerebral palsy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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