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Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants.

Ayoub Mitha 1, 2, * Laurence Foix-l'Hélias 1 Catherine Arnaud 3, 4 Stéphane Marret 5, 6 Rachel Vieux 7 Yannick Aujard 8 Gérard Thiriez 9 Béatrice Larroque 1, 10 Gilles Cambonie 11 Antoine Burguet 1, 12 Pascal Boileau 13 Jean Christophe Rozé 14, 15 Monique Kaminski 1 Patrick Truffert 2, 16 Pierre-Yves Ancel 1
* Corresponding author
1 UMR_S 953 - Recherche Epidémiologique en Santé Périnatale et Santé des Femmes et des Enfants
2 Unité de Néonatalogie
3 LEASP - Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps
4 Unité d'Epidémiologie Clinique
5 Service de pédiatrie néonatale et réanimation - neuropédiatrie [Rouen]
6 Néovasc - Endothélium microcirculatoire cérébral et lésions du système nerveux central au cours du développement
7 Unité de Néonatalogie
8 NICU - Neonatal Intensive Care Unit
9 Service Pédiatrie
10 Unité d'Epidémiologie et Recherche Clinique
11 Service de Néonatalogie
12 Service Pédiatrique
13 RISCQ - Risques cliniques et sécurité en santé des femmes et en santé périnatale
14 Service de Médecine Néonatale
15 CIC - Nantes
16 Unité de Recherche Epidémiologique sur la Qualité des Soins
Abstract : OBJECTIVE: To determine whether neonatal infections are associated with a higher risk of adverse neurodevelopment at 5 years of age in a population-based cohort of very preterm children. METHODS: We included all live births between 22 and 32 weeks of gestation, from 9 regions in France, in 1997 (EPIPAGE study). Of the 2665 live births, 2277 were eligible for a follow-up evaluation at 5 years of age: 1769 had a medical examination and 1495 underwent cognitive assessment. Cerebral palsy and cognitive impairment were studied as a function of early-onset sepsis (EOS) and late-onset sepsis (LOS), after adjustment for potential confounding factors, in multivariate logistic regression models. RESULTS: A total of 139 (5%) of the 2665 live births included in the study presented with EOS alone (without associated LOS), 752 (28%) had LOS alone (without associated EOS), and 64 (2%) displayed both EOS and LOS. At 5 years of age, the frequency of cerebral palsy was 9% (157 of 1769) and that of cognitive impairment was 12% (177 of 1495). The frequency of cerebral palsy was higher in infants with isolated EOS (odds ratio [OR]: 1.70 [95% confidence interval (CI): 0.84-3.45]) or isolated LOS (OR: 1.71 [95% CI: 1.14-2.56]) than in uninfected infants, and this risk was even higher in cases of combined EOS and LOS (OR: 2.33 [95% CI: 1.02-5.33]). There was no association between neonatal infection and cognitive impairment. CONCLUSIONS: Neonatal infections in these very preterm infants were associated with a higher risk of cerebral palsy at the age of 5 years, particularly in infants presenting with both EOS and LOS.
Keywords : cohort study neonatal infection neurodevelopmental outcome population-based study very preterm infants
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https://www.hal.inserm.fr/inserm-00912735
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Submitted on : Monday, December 2, 2013 - 3:38:37 PM
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UNIV-FCOMTE | INSERM | UNIV-NANTES | UPMC | UNIV-PARIS5 | UVSQ | EPIPAGE | USPC | COMUE-NORMANDIE | UNIROUEN | SORBONNE-UNIVERSITE | UNIV-TLSE3 | UNIV-PARIS | RISCQ | CNRS | SU-TI

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Ayoub Mitha, Laurence Foix-l'Hélias, Catherine Arnaud, Stéphane Marret, Rachel Vieux, et al.. Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants.. Pediatrics, American Academy of Pediatrics, 2013, 132 (2), pp.e372-80. ⟨10.1542/peds.2012-3979⟩. ⟨inserm-00912735⟩

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