title: Perinatal infections and neurodevelopmental outcome in very preterm and very low-birth-weight infants: a meta-analysis.
abstract: OBJECTIVE
  Perinatal infections are commonly present in preterm and very low-birth-weight (VLWB) infants and might contribute to adverse neurodevelopmental outcome.
  
  
  OBJECTIVE
  To summarize studies evaluating the effect of perinatal infections on neurodevelopmental outcome in very preterm/VLBW infants.
  
  
  METHODS
  On December 12, 2011, we searched Medline, PsycINFO, Embase, and Web of Knowledge for studies on infections and neurodevelopmental outcome. All titles and abstracts were assessed for eligibility by 2 independent reviewers. We also screened the reference lists of identified articles to search for additional eligible studies. Preselected criteria justified inclusion in this meta-analysis: (1) the study included infants born very preterm (≤32 weeks) and/or with VLBW (≤1500 g); (2) the study compared infants with and without perinatal infection; (3) there was follow-up using the Bayley Scales of Infant Development 2nd edition; and (4) results were published in an English-language peer-reviewed journal. The quality of each included study was assessed using the Newcastle-Ottawa Scale.
  
  
  RESULTS
  This meta-analysis includes 18 studies encompassing data on 13.755 very preterm/VLBW infants. Very preterm/VLBW infants with perinatal infections had poorer mental (d = -0.25; P < .001) and motor (d = -0.37; P < .001) development compared with very preterm/VLBW infants without infections. Mental development was most impaired by necrotizing enterocolitis (d = -0.40; P < .001) and meningitis (d = -0.37; P < .001). Motor development was most impaired by necrotizing enterocolitis (d = -0.66; P < .001). Chorioamnionitis did not affect mental (d = -0.05; P = .37) or motor (d = 0.19; P = .08) development.
  
  
  CONCLUSIONS
  Postnatal infections have detrimental effects on mental and motor development in very preterm/VLBW infants.
authors.affiliation: Department of Pediatrics, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Elvira O G
authors.initials: EO
authors.lastname: van Vliet
authors.forename: Jorrit F
authors.initials: JF
authors.lastname: de Kieviet
authors.forename: Jaap
authors.initials: J
authors.lastname: Oosterlaan
authors.forename: Ruurd M
authors.initials: RM
authors.lastname: van Elburg
mesh_terms: D001424:Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D019102:Infant, Very Low Birth Weight; D009422:Nervous System Diseases / Q000453:epidemiology*; D018743:Perinatal Care