Neonatal infection and long-term neurodevelopmental outcome in the preterm infant.
OBJECTIVE
The relationship between infection, the inflammatory response and adverse neurodevelopmental outcome in preterm infants is slowly being elucidated. The developing brain, particularly the periventricular white matter, is vulnerable to cytotoxic and hypoxic/ischemic injury, which places these infants at increased risk for abnormal cognitive and motor functioning. This review summarizes current data evaluating associations between infection and neurodevelopmental outcome in the preterm infant.


RESULTS
Preterm infants are at risk for intrauterine and postnatal infections. Recent studies have linked infection/inflammation associated with chorioamnionitis, sepsis and necrotizing enterocolitis with adverse neurodevelopmental outcome and impaired growth in preterm infants. Investigators have also shown associations between infection and brain injury, including severe intraventricular hemorrhage and periventricular leukomalacia. Very-low-birth-weight preterm infants are at substantial risk for neonatal infection, with associated morbidity and mortality. It is postulated that exposure of the preterm brain to inflammatory mediators during infectious episodes contributes to brain injury and poor developmental outcome.


CONCLUSIONS
Enhanced understanding of the interaction of infection, inflammation and brain injury will be critical to developing strategies to improve neurodevelopmental outcome in preterm infants.
Adams-Chapman
Ira
I
Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia 30322, USA. ira_adams-chapman@oz.ped.emory.edu
Stoll
Barbara J
BJ
D020345:Enterocolitis, Necrotizing / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D007239:Infections / Q000150:complications* / Q000382:microbiology / Q000821:virology; D008297:Male; D008581:Meningitis / Q000150:complications / Q000382:microbiology / Q000821:virology; D009420:Nervous System / Q000254:growth & development*; D011247:Pregnancy; D018805:Sepsis / Q000150:complications* / Q000382:microbiology / Q000821:virology