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Fungal infection and neurodevelopmental outcomes at 18-30 months in preterm infants

Qi Zhou1, Edmond Kelly2, Thuy Mai Luu3

  • 1Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.

Frontiers in Pediatrics
|May 8, 2023
PubMed
Abstract

Insights

Invasive fungal infections (IFI) in preterm infants are linked to higher mortality and neurodevelopmental issues. This study highlights the increased risks compared to non-fungal infections or no infections.

Area of Science:

  • Neonatalogy
  • Infectious Diseases
  • Neurodevelopmental Pediatrics

Background:

  • Invasive fungal infection (IFI) significantly impacts preterm infant mortality and morbidity.
  • Population-based data on long-term neurodevelopmental outcomes following IFI in preterm infants is lacking.

Purpose of the Study:

  • To investigate population-based incidence trends of IFI in preterm infants.
  • To analyze mortality, short-term morbidity, and long-term neurodevelopmental outcomes associated with IFI, non-fungal infections (NFI), and no infections in Canadian preterm infants.

Main Methods:

  • Retrospective cohort study of 8,408 infants born at <29 weeks gestational age (GA) in Canada (2009-2017).
  • Comparison of outcomes (mortality, neurodevelopmental impairment, in-hospital morbidity) among three groups: IFI, NFI, and no infections.
  • Follow-up at 18-30 months corrected age (CA) within the Canadian Neonatal Follow-Up Network.

Main Results:

  • IFI incidence was 1.3%, with no significant time trend. Higher GA was associated with lower IFI risk.
  • Significant neurodevelopmental impairment (sNDI) incidence was 44.26% for IFI vs. 21.63% (NFI) and 14.84% (no infections).
  • Mortality was 50% for IFI vs. 25.35% (NFI) and 22.25% (no infections). Adjusted analysis confirmed higher odds of sNDI and mortality for IFI infants.

Conclusions:

  • Preterm infants with IFI face substantially higher risks of mortality and adverse neurodevelopmental outcomes.
  • IFI poses a significant threat to the long-term well-being of extremely preterm infants.
  • These findings underscore the importance of IFI prevention and management in neonatal intensive care units.
Keywords:
fungalmorbiditymortalityneurodevelopmentpreterm

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