title: Neonatal infection and 5-year neurodevelopmental outcome of very preterm infants.
abstract: OBJECTIVE
  To determine whether neonatal infections are associated with a higher risk of adverse neurodevelopment at 5 years of age in a population-based cohort of very preterm children.
  
  
  METHODS
  We included all live births between 22 and 32 weeks of gestation, from 9 regions in France, in 1997 (EPIPAGE study). Of the 2665 live births, 2277 were eligible for a follow-up evaluation at 5 years of age: 1769 had a medical examination and 1495 underwent cognitive assessment. Cerebral palsy and cognitive impairment were studied as a function of early-onset sepsis (EOS) and late-onset sepsis (LOS), after adjustment for potential confounding factors, in multivariate logistic regression models.
  
  
  RESULTS
  A total of 139 (5%) of the 2665 live births included in the study presented with EOS alone (without associated LOS), 752 (28%) had LOS alone (without associated EOS), and 64 (2%) displayed both EOS and LOS. At 5 years of age, the frequency of cerebral palsy was 9% (157 of 1769) and that of cognitive impairment was 12% (177 of 1495). The frequency of cerebral palsy was higher in infants with isolated EOS (odds ratio [OR]: 1.70 [95% confidence interval (CI): 0.84-3.45]) or isolated LOS (OR: 1.71 [95% CI: 1.14-2.56]) than in uninfected infants, and this risk was even higher in cases of combined EOS and LOS (OR: 2.33 [95% CI: 1.02-5.33]). There was no association between neonatal infection and cognitive impairment.
  
  
  CONCLUSIONS
  Neonatal infections in these very preterm infants were associated with a higher risk of cerebral palsy at the age of 5 years, particularly in infants presenting with both EOS and LOS.
authors.affiliation: Neonatal Unit Hôpital Jeanne de Flandre, Lille, France. ayoub.mitha@yahoo.fr
authors.forename: Ayoub
authors.initials: A
authors.lastname: Mitha
authors.forename: Laurence
authors.initials: L
authors.lastname: Foix-L'Hélias
authors.forename: Catherine
authors.initials: C
authors.lastname: Arnaud
authors.forename: Stéphane
authors.initials: S
authors.lastname: Marret
authors.forename: Rachel
authors.initials: R
authors.lastname: Vieux
authors.forename: Yannick
authors.initials: Y
authors.lastname: Aujard
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiriez
authors.forename: Béatrice
authors.initials: B
authors.lastname: Larroque
authors.forename: Gilles
authors.initials: G
authors.lastname: Cambonie
authors.forename: Antoine
authors.initials: A
authors.lastname: Burguet
authors.forename: Pascal
authors.initials: P
authors.lastname: Boileau
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Rozé
authors.forename: Monique
authors.initials: M
authors.lastname: Kaminski
authors.forename: Patrick
authors.initials: P
authors.lastname: Truffert
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Ancel
mesh_terms: D002547:Cerebral Palsy / Q000175:diagnosis / Q000453:epidemiology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D015331:Cohort Studies; D003428:Cross Infection / Q000175:diagnosis* / Q000453:epidemiology* / Q000635:transmission; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D019102:Infant, Very Low Birth Weight; D018445:Infectious Disease Transmission, Vertical; D008137:Longitudinal Studies; D008297:Male; D009483:Neuropsychological Tests; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis* / Q000453:epidemiology* / Q000635:transmission
keywords: cohort study; neonatal infection; neurodevelopmental outcome; population-based study; very preterm infants