Context: Neonatal infections are frequent complications of extremely low- birth- weight (ELBW) infants receiving intensive care. Objective: To determine if neonatal infections in ELBW infants are associated with incre...
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Context: Neonatal infections are frequent complications of extremely low- birth- weight (ELBW) infants receiving intensive care. Objective: To determine if neonatal infections in ELBW infants are associated with increased risks of adverse neurodevelopmental and growth sequelae in early childhood. Design, Setting, and Participants: Infants weighing 401 to 1000 g at birth (born in 1993- 2001) were enrolled in a prospectively collected very low- birth- weight registry at academic medical centers participating in the National Institute of Child Health and Human Development Neonatal Research Network. Neurodevelopmental and growth outcomes were assessed at a comprehensive follow- up visit at 18 to 22 months of corrected gestational age and compared by infection group. Eighty percent of survivors completed the follow- up visit and 6093 infants were studied. Registry data were used to classify infants by type of infection: uninfected (n=2161), clinical infection alone (n=1538), sepsis (n=1922), sepsis and necrotizing enterocolitis (n=279), or meningitis with or without sepsis (n=193). Main Outcome Measures: Cognitive and neuromotor development, neurologic status, vision and hearing, and growth (weight, length, and head circumference) were assessed at follow- up. Results: The majority of ELBW survivors (65% ) had at least 1 infection during their hospitalization after birth. Compared with uninfected infants, those in each of the 4 infection groups were significantly more likely to have adverse neurodevelopmental outcomes at follow- up, including cerebral palsy (range of significant odds ratios [ORs], 1.4- 1.7), low Bayley Scales of Infant Development II scores on the mental development index (ORs, 1.3- 1.6)- and psychomotor development index (ORs, 1.5- 2.4), and vision impairment (ORs, 1.3- 2.2). Infection in the neonatal period was also associated with impaired head growth, a known predictor of poor neurodevelopmental outcome. Conclusions: This large cohort study suggests t
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