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Motor, Cognitive and Behavioral outcome at school age of Preterms with Late Onset Sepsis

By M.H. van der Ree


Background Late onset sepsis is still a common complication of admission to the neonatal intensive care unit. Late onset sepsis carries a high risk for subsequent neurodevelopmental impairment in the preterm infant. The objectives of this study were to determine the motor, cognitive and behavioral outcome of the children at school age and to determine whether the outcome was associated with characteristics of the sepsis. Methods We retrospectively studied patients from the Neonatal Intensive Care Unit of the University Medical Center Groningen admitted in 2000 and 2001. We included 30 preterm infants (GA<32weeks and/or BW <1500grams) with a culture-proven late onset sepsis, defined as a positive blood culture occurring after more than 96 hours after birth. We also included 18 control infants without sepsis, born during the same period and matched for and gestational age. Results Children with late onset sepsis were at higher risk for impaired motor skills at school age (Odds ratio [OR] 3.30, 95% confidence interval [CI] 0.98-11.07). Especially fine motor skills were affected (OR 5.46 95% CI 1.52-19.58). Total and verbal IQ were 89, respectively 91, which was significantly lower than the control group: 98 respectively 102. Several other neuropsychological functions such as verbal memory and attentional control, were also impaired in children with late onset sepsis. The incidence of behavioral problems was comparable between the groups. Within the group of children with late onset sepsis, more than one episode of sepsis and sepsis caused by gram-negative bacteria were risk factors for worse outcome. Conclusion Preterm infants who develop late onset sepsis are at increased risk for adverse motor and cognitive outcome at school age compared to controls.

Year: 2010
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