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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal infection and long-term neurodevelopmental outcome in the preterm infant
Ira Adams-Chapman1, Barbara J Stoll
1Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia 30322, USA. ira_adams-chapman@oz.ped.emory.edu
Insights
Infections and inflammation in preterm infants are linked to poor neurodevelopmental outcomes and brain injury. Understanding these connections is key to improving cognitive and motor functions in vulnerable newborns.
Area of Science:
- Neonatal research
- Neuroscience
- Developmental pediatrics
Background:
- Preterm infants face risks from intrauterine and postnatal infections.
- The developing brain, especially white matter, is susceptible to injury from infection and inflammation.
- Infection/inflammation is associated with conditions like chorioamnionitis, sepsis, and necrotizing enterocolitis.
Purpose of the Study:
- To review current data on the association between infection and neurodevelopmental outcomes in preterm infants.
- To elucidate the relationship between infection, inflammation, and adverse neurodevelopmental outcomes.
- To highlight the vulnerability of the preterm brain to injury.
Main Methods:
- Literature review of current data.
- Analysis of studies evaluating infection and neurodevelopmental outcomes.
- Synthesis of findings on brain injury and developmental impact.
Main Results:
- Infection/inflammation is linked to adverse neurodevelopmental outcomes and impaired growth in preterm infants.
- Associations found between infection and brain injuries like intraventricular hemorrhage and periventricular leukomalacia.
- Very-low-birth-weight infants are at high risk for neonatal infection and related mortality.
Conclusions:
- Infection and inflammation contribute to brain injury and poor developmental outcomes in preterm infants.
- Understanding the interplay of infection, inflammation, and brain injury is crucial.
- Developing strategies to mitigate infection/inflammation is vital for improving neurodevelopmental outcomes.
Purpose Of Review:
The relationship between infection, the inflammatory response and adverse neurodevelopmental outcome in preterm infants is slowly being elucidated. The developing brain, particularly the periventricular white matter, is vulnerable to cytotoxic and hypoxic/ischemic injury, which places these infants at increased risk for abnormal cognitive and motor functioning. This review summarizes current data evaluating associations between infection and neurodevelopmental outcome in the preterm infant.
Recent Findings:
Preterm infants are at risk for intrauterine and postnatal infections. Recent studies have linked infection/inflammation associated with chorioamnionitis, sepsis and necrotizing enterocolitis with adverse neurodevelopmental outcome and impaired growth in preterm infants. Investigators have also shown associations between infection and brain injury, including severe intraventricular hemorrhage and periventricular leukomalacia. Very-low-birth-weight preterm infants are at substantial risk for neonatal infection, with associated morbidity and mortality. It is postulated that exposure of the preterm brain to inflammatory mediators during infectious episodes contributes to brain injury and poor developmental outcome.
Summary:
Enhanced understanding of the interaction of infection, inflammation and brain injury will be critical to developing strategies to improve neurodevelopmental outcome in preterm infants.
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