Original articleAdverse Neurodevelopment in Preterm Infants with Postnatal Sepsis or Necrotizing Enterocolitis is Mediated by White Matter Abnormalities on Magnetic Resonance Imaging at Term
Section snippets
Subjects
Infants born before 30 weeks' gestation and admitted to the Royal Women's Hospital, Melbourne, Australia, between April 2001 and December 2003 were recruited for a prospective cohort MRI study. Two hundred and eight infants were recruited, which represents 67% of all eligible infants. Four of these were excluded because of congenital and chromosomal abnormalities. For the remaining infants (n = 204) there were no significant differences in the perinatal or postnatal characteristics of the
Cohort Characteristics
Of the 204 eligible infants, MRI images were not available for 3 infants, and for 9 infants follow-up was not possible because 2 infants had died, 1 infant had moved overseas, and 6 families either refused further participation or had withdrawn consent. Of the 2 infants who died, 1 had 3 episodes of confirmed sepsis with coagulase-negative staphylococci (CONS) and also had NEC requiring surgery, and the other had no episodes of confirmed sepsis or NEC. In relation to the remaining 10 infants
Discussion
We found that sepsis/NEC in the premature infant is associated with a higher prevalence and severity of WMA on MRI at term-equivalent age. Subgroups of infants with CONS, which accounted for 73% of sepsis episodes, infants with any confirmed sepsis and infants with NEC all had elevated rates of WMA compared with infants in the no-sepsis/NEC group. However, only infants with NEC had substantially higher rates of GMA. This study also demonstrated that premature infants with sepsis/NEC had delayed
Acknowledgments
We are grateful to Mr. Michael Keane and the MRI Department at the Royal Children's Hospital in Melbourne, Australia for assistance with MRI. We are grateful to Ms. Kelly Howard, Ms. Karli Trevaud for assisting with neurodevelopmental assessments, Dr. Peter Filan, Dr. Noni Davis, and Dr. Geoff Ford for the medical assessments for the children, and Ms. Kate Callanan for assistance with coordinating follow-up. We wish to acknowledge the Murdoch Children's Research Institute and grant support from
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