Neonatal sepsis and neurodevelopment in very low birth weight infants in Matanzas, Cuba 2006-2010: a prospective cohort study.
BACKGROUND
Neonatal sepsis has been associated with poor neurodevelopmental outcome in very low birth weight infants (VLBW infants). The impact of neonatal sepsis on neurodevelopment in very low birth weight infants discharged from Cuban neonatal intensive care units is unknown.


OBJECTIVE
To determine the impact of neonatal sepsis as a risk factor of neurodevelopmental disorders in a Cuban very low birth weight infants population.


METHODS
A cohort study was carried out that enrolled 89 infants with birth weight less than 1500 g who were admitted during the period 2006-2010 to the Teaching Provincial Gynecological and Obstetrical Hospital of Matanzas. All patients were followed-up at the outpatient clinic until two years of corrected gestational age. Then they were divided into two groups: those who had been diagnosed with neonatal sepsis (n=19) and those who had not (n=70). The association power of neonatal sepsis with neurodevelopmental disorders was determined with calculation of relative risk (RR) and their confidence intervals at 95% (CI95%). A multivariate analysis with logistic regression enabled us to compare sepsis with other neonatal variables as risk factors.


RESULTS
Very low birth weight infants with neonatal sepsis had an increased risk of neurodevelopmental disorders (47.4 vs 17.1%; RR 2.7 CI95% 1.3-5.5; p=0.005). This risk was significant after correction for other variables (male sex, mechanical respiratory assistance, bronchopulmonary dysplasia and hyperbilirrubinemia >15 mg/dl) (odds ratio 4.0; CI95% 1.1-14.3; p=0.03).


CONCLUSIONS
Neonatal sepsis should be considered an important factor among the multiple events related to poor neurodevelopmental outcome in the preterm newborn.
Hospital Ginecobstétrico Docente Provincial de Matanzas, Universidad de Ciencias Médicas de Matanzas, Cuba. Address: Hospital Gineco-obstétrico Provincial de Matanzas, Santa Cristina entre Unión y Santa Cecilia, Matanzas, Cuba. Email: grcastellanos.mtz@infomed.sld.cu.
Gerardo Rogelio
GR
Robaina Castellanos
Hospital Pediátrico Provincial de Matanzas, Universidad de Ciencias Médicas de Matanzas, Cuba.
Solangel de la Caridad
Sde L
Riesgo Rodríguez
D001724:Birth Weight; D002675:Child, Preschool; D015331:Cohort Studies; D003462:Cuba / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D000071074:Neonatal Sepsis / Q000150:complications*; D065886:Neurodevelopmental Disorders / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors
brain damage; child development; newborn; preterm infant; sepsis; very low birth weight infants