Abstract：Objective To investigate the infection factors associated with neurodysplasia in early and moderately preterm infants at a corrected age of 18 months. Methods The preterm infants with a gestational age of 28 weeks to < 34 weeks who were admitted to the neonatal intensive care unit and followed up at the outpatient service for high-risk preterm infants from June 2015 to December 2018 were enrolled as subjects. At a corrected age of 18 months, the revised Bayley Scales of Infant Development was used to evaluate neurodevelopment. Univariate and multivariate logistic regression analyses were used to investigate the infection factors affecting neurodevelopment. Results A total of 138 early or moderately preterm infants were enrolled, among whom 59 had neurodysplasia at a corrected age of 18 months. The univariate logistic regression analysis showed that neurodysplasia was associated with late-onset infection, positive blood culture, and other systemic infections (P < 0.05). The multivariate logistic regression analysis showed that late-onset infection was an independent risk factor for neurodysplasia (OR=1.510, 95%CI:1.133-3.600, P < 0.05). Conclusions Late-onset infection can increase the risk of neurodysplasia in early and moderately preterm infants.
CHANG Qin,HU Bin,WANG Cheng-Ju et al. Infection factors associated with neurodysplasia in early and moderately preterm infants[J]. CJCP, 2019, 21(9): 856-860.
Polin RA, Denson S, Brady MT, et al. Epidemiology and diagnosis of health care-associated infections in the NICU[J]. Pediatrics, 2012, 129(4):e1104-e1109.
[2]
Schmidt B, Roberts RS, Davis PG, et al. Prediction of late death or disability at age 5 years using a count of 3 neonatal morbidities in very low birth weight infants[J]. J Pediatr, 2015, 167(5):982-986.e2.
[3]
van Vliet EO, de Kieviet JF, Oosterlaan J, et al. Perinatal infections and neurodevelopmental outcome in very preterm and very low-birth-weight infants:a meta-analysis[J]. JAMA Pediatr, 2013, 167(7):662-668.
[4]
Mitha A, Foix-L'Hélias L, Arnaud C, et al. Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants[J]. Pediatrics, 2013, 132(2):e372-e380.
Hentges CR, Silveira RC, Procianoy RS, et al. Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight[J]. J Pediatr (Rio J), 2014, 90(1):50-57.
[7]
Glass HC, Bonifacio SL, Chau V, et al. Recurrent postnatal infections are associated with progressive white matter injury in premature infants[J]. Pediatrics, 2008, 122(2):299-305.
Shah DK, Lavery S, Doyle LW, et al. Use of 2-channel bedside electroencephalogram monitoring in term-born encephalopathic infants related to cerebral injury defined by magnetic resonance imaging[J]. Pediatrics, 2006, 118(1):47-55.
[12]
Polin RA; Committee on Fetus and Newborn. Management of neonates with suspected or proven early-onset bacterial sepsis[J]. Pediatrics, 2012, 129(5):1006-1015.
Advani S, Reich NG, Sengupta A, et al. Central line-associated bloodstream infection in hospitalized children with peripherally inserted central venous catheters:extending risk analyses outside the intensive care unit[J]. Clin Infect Dis, 2011, 52(9):1108-1115.
[15]
Benjamin DK Jr, Stoll BJ, Fanaroff AA, et al. Neonatal candidiasis among extremely low birth weight infants:risk factors, mortality rates, and neurodevelopmental outcomes at 18 to 22 months[J]. Pediatrics, 2006, 117(1):84-92.
Hentges CR, Silveira RC, Procianoy RS, et al. Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight[J]. J Pediatr (Rio J), 2014, 90(1):50-57.
[18]
Hemels MA, Nijman J, Leemans A, et al. Cerebral white matter and neurodevelopment of preterm infants after coagulase-negative staphylococcal sepsis[J]. Pediatr Crit Care Med, 2012, 13(6):678-684.
Lee I, Neil JJ, Huettner PC, et al. The impact of prenatal and neonatal infection on neurodevelopmental outcomes in very preterm infants[J]. J Perinatol, 2014, 34(10):741-747.
