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Short- and Long-Term Neurodevelopmental Outcomes of Very Preterm Infants with Neonatal Sepsis: A Systematic Review and Meta-Analysis

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Victorian Infant Brain Study, Murdoch Children’s Research Institute, Royal Children’s Hospital, Flemington Road, Parkville, VIC 3052, Australia
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Developmental Imaging, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
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Melbourne Medicine School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC 3052, Australia
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Department of Paediatrics, The University of Melbourne, Parkville, VIC 3052, Australia
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Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia
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Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
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Neuroscience Research, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
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Department of Neurosurgery, Royal Children’s Hospital, Parkville, VIC 3052, Australia
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Author to whom correspondence should be addressed.
Children 2019, 6(12), 131; https://doi.org/10.3390/children6120131
Received: 7 November 2019 / Revised: 18 November 2019 / Accepted: 23 November 2019 / Published: 1 December 2019
(This article belongs to the Section Child Neurology)
Sepsis is commonly experienced by infants born very preterm (<32 weeks gestational age and/or <1500 g birthweight), but the long-term functional outcomes are unclear. The objective of this systematic review was to identify observational studies comparing neurodevelopmental outcomes in very preterm infants who had blood culture-proven neonatal sepsis with those without sepsis. Twenty-four studies were identified, of which 19 used prespecified definitions of neurodevelopmental impairment and five reported neurodevelopmental outcomes as continuous variables. Meta-analysis was conducted using 14 studies with defined neurodevelopmental impairment and demonstrated that very preterm infants with neonatal sepsis were at higher risk of impairments, such as cerebral palsy and neurosensory deficits, compared with infants without sepsis (OR 3.18; 95% CI 2.29–4.41). Substantial heterogeneity existed across the studies (I2 = 83.1, 95% CI 73–89). The five studies that reported outcomes as continuous variables showed no significant difference in cognitive performance between sepsis and non-sepsis groups. Neonatal sepsis in very preterm infants is associated with increased risk of neurodevelopmental disability. Due to the paucity of longitudinal follow-up data beyond 36 months, the long-term cognitive effect of neonatal sepsis in very preterm infants could not be conclusively determined. Effects on the development of minor impairment could not be assessed, due to the small numbers of infants included in the studies. View Full-Text
Keywords: premature; brain; infection; infant; development; cognition premature; brain; infection; infant; development; cognition
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Cai, S.; Thompson, D.K.; Anderson, P.J.; Yang, J. .-M. Short- and Long-Term Neurodevelopmental Outcomes of Very Preterm Infants with Neonatal Sepsis: A Systematic Review and Meta-Analysis. Children 2019, 6, 131.

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