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Maternal fever at birth and non-verbal intelligence at age 9 years in preterm infants
Olaf Dammann1, Johannes Drescher, Norbert Veelken
1Department of Obstetrics, Prenatal Medicine, and General Gynecology, Hannover Medical School, Germany. dammann.olaf@mh-hannover.de
Insights
Perinatal infections may increase the risk of long-term cognitive deficits in preterm infants. Maternal fever and clinical infections during pregnancy were linked to lower cognitive scores in children at age 9.
Area of Science:
- Neonatal Health
- Developmental Pediatrics
- Infectious Diseases
Background:
- Preterm infants are at higher risk for neurodevelopmental challenges.
- The role of perinatal infections in long-term cognitive outcomes requires further investigation.
Purpose of the Study:
- To determine if perinatal infection characteristics are associated with cognitive limitations in preterm infants at age 9.
- To identify specific infection-related factors contributing to cognitive deficits.
Main Methods:
- Analysis of data from 294 preterm infants (birthweight ≤1500g, <37 weeks gestation) assessed at age 9.
- Cognitive function evaluated using the Kaufman Assessment Battery for Children (K-ABC) non-verbal scale.
- Comparison of children with low K-ABC scores (cases) to those with average scores (controls).
Main Results:
- Low gestational age, maternal education, and nationality were associated with lower non-verbal K-ABC scores.
- Neonatal brain damage (intraventricular hemorrhage) and cerebral palsy (CP) were linked to impaired cognitive function.
- Maternal fever at birth (OR 3.6) and clinical chorioamnionitis were more common in children with cognitive deficits.
Conclusions:
- Perinatal infections, including maternal fever, may contribute to an increased risk of long-term cognitive deficits in preterm infants.
- Early identification and management of perinatal infections could be crucial for improving cognitive outcomes in this population.
Abstract:
To test the hypothesis that characteristics of perinatal infection are associated with long-term cognitive limitations among preterm infants, we analyzed data from 294 infants (142 females, 152 males) < or = 1500 g birthweight and <37 completed weeks of gestation who were examined at age 9 years. We identified 47 children (20 females, 27 males) who had a non-verbal Kaufman Assessment Battery for Children (K-ABC) scale standard value below 70, i.e. more than 2 SDs below the age-adjusted mean. The 247 children (122 females, 125 males) with a score > or = 70 served as control participants. Maternal nationality and education, and low gestational age were significantly associated with a K-ABC non-verbal standard value <70. Both neonatal brain damage (intraventricular hemorrhage) and long-term sequelae (cerebral palsy [CP], diagnosed at age 6 years) were significantly associated with a below-normal non-verbal K-ABC score. Maternal fever at birth was present in five cases (11%) and eight controls (3%; odds ratio 3.6, 95% confidence interval 1.1 to 11.4). Clinical chorioamnionitis and preterm labor and/or premature rupture of membranes (as opposed to toxemia and other initiators of preterm delivery) were also more common among cases than control participants. When adjusting for potential confounders such as gestational age, maternal education and nationality, and CP, the risk estimate for maternal fever remained unchanged (3.8, 0.97 to 14.6). We conclude that perinatal infection might indeed contribute to an increased risk for long-term cognitive deficits in preterm infants.