Related Experiment Video
Updated: Jul 12, 2025
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Long-Term Neurodevelopmental Impairment among Very Preterm Infants with Sepsis, Meningitis, and Intraventricular
Qi Zhou1, Melissa Ong2, Xiang Y Ye3
1Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.
Insights
Late onset meningitis in very preterm infants (VPIs) is linked to significantly higher rates of neurodevelopmental delay. Intraventricular hemorrhage (IVH) further increases risks, showing an additive effect on long-term outcomes.
Area of Science:
- Neonatal neurology
- Pediatric infectious diseases
- Developmental pediatrics
Background:
- Sepsis and intraventricular hemorrhage (IVH) negatively impact neurodevelopment in very preterm infants (VPIs).
- The long-term neurodevelopmental effects of meningitis and the combined impact of meningitis and IVH in VPIs are less understood.
Purpose of the Study:
- To investigate the long-term neurodevelopmental outcomes of VPIs with late onset sepsis and meningitis.
- To examine the influence of IVH on these outcomes in Canadian VPIs.
Main Methods:
- Retrospective cohort study of infants <29 weeks gestational age admitted to Canadian tertiary NICUs (2010-2016).
- Analysis of data from the Canadian Neonatal Network (CNN) and Canadian Neonatal Follow-Up Network (CNFUN).
Main Results:
- Infants with late onset meningitis had significantly higher rates of significant neurodevelopmental delay (32.0%) compared to those with late onset bloodstream infection only (22.9%) and no infection (15.0%).
- Similar trends were observed for neurodevelopmental impairment, cerebral palsy, and specific Bayley-III scores.
- Intraventricular hemorrhage (IVH) demonstrated an additive effect on adverse outcomes across all infection groups, but no multiplicative effect with meningitis.
Conclusions:
- Adverse neurodevelopmental outcomes increase progressively from no infection to bloodstream infection to meningitis in VPIs.
- Intraventricular hemorrhage exacerbates these risks in an additive manner.
Introduction:
Sepsis and intraventricular hemorrhage (IVH) are associated with poorer long-term neurodevelopmental outcomes in very preterm infants (VPIs), but less is known about the long-term effect of meningitis and the combined impact of both meningitis and IVH. Our objective was to examine the long-term neurodevelopmental outcomes of VPIs with late onset sepsis and meningitis, with and without IVH, in Canada.
Methods:
We conducted a retrospective cohort study of all infants <29 weeks GA who were admitted to 26 tertiary-level neonatal intensive care units in the Canadian Neonatal Network (CNN) and Canadian Neonatal Follow-Up Network (CNFUN) databases, from January 1, 2010, to December 31, 2016.
Results:
Of the 6,322 infants in the cohort, 4,575 had no infection, 1,590 had late onset culture-positive bloodstream infection (CPBSI) only, and 157 had late onset meningitis. There was a significant (p < 0.05) trend of increasing rates of significant neurodevelopmental delay (sNDI) when comparing infants with no infection (sNDI rate 15.0%), late onset CPBSI (sNDI rate 22.9%), and late onset meningitis (sNDI rate 32.0%), even after adjustment for infant characteristics. Similar trends were observed for neurodevelopmental impairment, cerebral palsy, and individual Bayley-III scores <85 for cognitive, language, and motor development. There was an additive effect of IVH in all infant categories, but there was no multiplicative effect between IVH and late onset meningitis.
Conclusion:
There was an increasing trend of adverse neurodevelopmental outcomes when infants with no infection, late onset CPBSI and late onset meningitis are compared. IVH had an additive effect.
