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Published on: August 25, 2022
Brain volume and neurodevelopment at 13 years following sepsis in very preterm infants
Deanne K Thompson1,2,3,4, Shirley Cai5,6,7, Claire E Kelly5,6,8
1Victorian Infant Brain Studies, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia. deanne.thompson@mcri.edu.au.
Insights
Neonatal sepsis in very preterm infants did not significantly impact long-term brain growth or neurodevelopmental outcomes by age 13. These findings suggest sepsis does not disrupt brain development or cause functional issues in early adolescence.
Area of Science:
- Neuroscience
- Pediatrics
- Developmental Biology
Background:
- Neonatal infection associations with brain growth and neurodevelopment in very preterm (VP) infants are not well understood.
- Previous research suggests potential negative short-term impacts of neonatal sepsis on VP infants.
Purpose of the Study:
- To assess the long-term effects of neonatal sepsis on brain growth from term-equivalent age to 13 years in VP infants.
- To evaluate the association between neonatal sepsis and 13-year brain volume and neurodevelopmental outcomes.
Main Methods:
- Longitudinal brain MRI scans analyzed for 68 cortical and 14 subcortical regions in 216 VP infants (born <30 weeks gestation) from term-equivalent to 13 years.
- Neurodevelopmental assessments at age 13 for 177 children, comparing 63 with neonatal sepsis to 114 without.
- Mixed-effects models and linear regressions used to compare brain volumetric growth and outcomes between sepsis and no-sepsis groups.
Main Results:
- No significant differences were observed in brain volumetric growth trajectories between infants with and without neonatal sepsis.
- Brain volumes at age 13 years were similar between the sepsis and no-sepsis groups.
- Neurodevelopmental outcomes at age 13 years showed no significant differences between the groups.
Conclusions:
- Neonatal sepsis in very preterm infants does not appear to disrupt subsequent brain development up to adolescence.
- Neonatal sepsis does not seem to have significant long-term functional consequences in early adolescence for VP infants.
- The long-term links between neonatal sepsis and neurodevelopment in VP infants require further investigation.
Background:
Associations of neonatal infection with brain growth and later neurodevelopmental outcomes in very preterm (VP) infants are unclear. This study aimed to assess associations of neonatal sepsis in VP infants with (1) brain growth from term-equivalent age to 13 years; and (2) 13-year brain volume and neurodevelopmental outcomes.
Methods:
224 infants born VP ( < 30 weeks' gestation/<1250 g birthweight) were recruited. Longitudinal brain volumes for 68 cortical and 14 subcortical regions were derived from MRI at term-equivalent, 7 and/or 13 years of age for 216 children (79 with neonatal sepsis and 137 without). 177 children (79%) had neurodevelopmental assessments at age 13. Of these, 63 with neonatal sepsis were compared with 114 without. Brain volumetric growth trajectories across time points were compared between sepsis and no-sepsis groups using mixed effects models. Linear regressions compared brain volume and neurodevelopmental outcome measures at 13 years between sepsis and no sepsis groups.
Results:
Growth trajectories were similar and there was little evidence for differences in brain volumes or neurodevelopmental domains at age 13 years between those with or without sepsis.
Conclusions:
Neonatal sepsis in children born VP does not appear to disrupt subsequent brain development, or to have functional consequences in early adolescence.
Impact Statement:
Neonatal sepsis has been associated with poorer short-term neurodevelopmental outcomes and reduced brain volumes in very preterm infants. This manuscript provides new insights into the long-term brain development and neurodevelopmental outcomes of very preterm-born children who did or did not have neonatal sepsis. We found that regional brain volumes up to 13 years, and neurodevelopmental outcomes at age 13, were similar between those with and without neonatal sepsis. The links between neonatal sepsis and long-term neurodevelopment remain unclear.
