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J Pediatr. 2017 Aug;187:43-49.e1. doi: 10.1016/j.jpeds.2017.04.045. Epub 2017 May 16.

Neurocognitive Outcomes at 10 Years of Age in Extremely Preterm Newborns with Late-Onset Bacteremia.

Author information

1
Tufts University School of Medicine, Boston, MA.
2
Department of Newborn Medicine, Tufts Medical Center, Boston, MA. Electronic address: kbabata@tuftsmedicalcenter.org.
3
Harvard Medical School, Boston, MA; Department of Neurology, Boston Children's Hospital, Boston, MA.
4
Harvard Medical School, Boston, MA; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA.
5
Department of Pediatrics, Division of Pediatric Neurology, Boston University Medical Center, Boston, MA.
6
Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA.
7
Department of Pediatrics, University of North Carolina, Chapel Hill, NC.
8
Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA; Perinatal Neuroepidemiology Unit, Hannover Medical School, Hannover, Germany.
9
Boston Children's Hospital, Boston, MA.
10
Tufts Medical Center, Boston, MA.
11
Baystate Medical Center.
12
University of Massachusetts Medical School, Worcester, MA.
13
Yale University School of Medicine, New Haven, CT.
14
Wake Forest University Baptist Medical Center, Winston-Salem, NC.
15
University Health Systems of Eastern Carolina, Greenville, NC.
16
North Carolina Children's Hospital, Chapel Hill, NC.
17
Helen DeVos Children's Hospital, Grand Rapids, MI.
18
Sparrow Hospital, Lansing, MI.
19
University of Chicago Medical Center, Chicago, IL.
20
William Beaumont Hospital, Royal Oak, MI.

Abstract

OBJECTIVE:

To evaluate the difference in 10-year neurocognitive outcomes between extremely low gestational age newborns without bacteremia and those with suspected or confirmed late-onset bacteremia.

STUDY DESIGN:

Neurocognitive function was evaluated at 10 years of age in 889 children born at <28 weeks of gestation and followed from birth. Definite (culture-positive) late-onset bacteremia during postnatal weeks 2-4 was identified in 223 children, and 129 children had suspected bacteremia.

RESULTS:

Infants with the lowest gestational age and birth weight z-score had the highest prevalence of definite and suspected late-onset bacteremia. Compared with peers with no or suspected bacteremia, infants with definite bacteremia performed worse on tests of general cognitive ability, language, academic achievement, and executive function, even after adjustment for potential confounders. Adjustment for low IQ attenuated the associations between bacteremia and all dysfunctions at age 10 years. Children with suspected bacteremia did not differ appreciably from those with no evidence of bacteremia. The motor domain was unaffected.

CONCLUSIONS:

Extremely low gestational age newborns who had definite late bacteremia during postnatal weeks 2-4 are at heightened risk of neurocognitive limitations at age 10 years.

KEYWORDS:

academic function; cognition; executive function; extremely low gestational age newborn; neurodevelopment; school age; sensorimotor impairment; sepsis

PMID:
28526224
PMCID:
PMC5533634
DOI:
10.1016/j.jpeds.2017.04.045
[Indexed for MEDLINE]
Free PMC Article

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