H Reeve Bright1, Kikelomo Babata2, Elizabeth N Allred3, Carmina Erdei4, Karl C K Kuban5, Robert M Joseph6, T Michael O'Shea7, Alan Leviton3, Olaf Dammann8. 1. Tufts University School of Medicine, Boston, MA. 2. Department of Newborn Medicine, Tufts Medical Center, Boston, MA. Electronic address: kbabata@tuftsmedicalcenter.org. 3. Harvard Medical School, Boston, MA; Department of Neurology, Boston Children's Hospital, Boston, MA. 4. Harvard Medical School, Boston, MA; Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Boston, MA. 5. Department of Pediatrics, Division of Pediatric Neurology, Boston University Medical Center, Boston, MA. 6. Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA. 7. Department of Pediatrics, University of North Carolina, Chapel Hill, NC. 8. Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA; Perinatal Neuroepidemiology Unit, Hannover Medical School, Hannover, Germany.
Abstract
OBJECTIVE: To evaluate the difference in 10-year neurocognitive outcomes between extremely low gestational age newborns without bacteremia and those with suspected or confirmed late-onset bacteremia. STUDY DESIGN: Neurocognitive function was evaluated at 10 years of age in 889 children born at <28 weeks of gestation and followed from birth. Definite (culture-positive) late-onset bacteremia during postnatal weeks 2-4 was identified in 223 children, and 129 children had suspected bacteremia. RESULTS: Infants with the lowest gestational age and birth weight z-score had the highest prevalence of definite and suspected late-onset bacteremia. Compared with peers with no or suspected bacteremia, infants with definite bacteremia performed worse on tests of general cognitive ability, language, academic achievement, and executive function, even after adjustment for potential confounders. Adjustment for low IQ attenuated the associations between bacteremia and all dysfunctions at age 10 years. Children with suspected bacteremia did not differ appreciably from those with no evidence of bacteremia. The motor domain was unaffected. CONCLUSIONS: Extremely low gestational age newborns who had definite late bacteremia during postnatal weeks 2-4 are at heightened risk of neurocognitive limitations at age 10 years.
OBJECTIVE: To evaluate the difference in 10-year neurocognitive outcomes between extremely low gestational age newborns without bacteremia and those with suspected or confirmed late-onset bacteremia. STUDY DESIGN: Neurocognitive function was evaluated at 10 years of age in 889 children born at <28 weeks of gestation and followed from birth. Definite (culture-positive) late-onset bacteremia during postnatal weeks 2-4 was identified in 223 children, and 129 children had suspected bacteremia. RESULTS:Infants with the lowest gestational age and birth weight z-score had the highest prevalence of definite and suspected late-onset bacteremia. Compared with peers with no or suspected bacteremia, infants with definite bacteremia performed worse on tests of general cognitive ability, language, academic achievement, and executive function, even after adjustment for potential confounders. Adjustment for low IQ attenuated the associations between bacteremia and all dysfunctions at age 10 years. Children with suspected bacteremia did not differ appreciably from those with no evidence of bacteremia. The motor domain was unaffected. CONCLUSIONS: Extremely low gestational age newborns who had definite late bacteremia during postnatal weeks 2-4 are at heightened risk of neurocognitive limitations at age 10 years.
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