Objective To evaluate the difference in 10-year neurocognitive outcomes among extremely low gestational age newborns without bacteremia or with suspected or confirmed late-onset bacteremia. Study design Neurocognitive function was evaluated at 10 years of age in 889 children born at <28 weeks of gestation and followed from birth. Definite (culture positive) late-onset bacteremia during postnatal weeks 2–4 was identified in 223 children and 129 had suspected bacteremia. Results Infants with the lowest gestational age and birth weight Z-score had the highest prevalence of definite and suspected late-onset bacteremia. When compared with peers with no or suspected bacteremia, infants with definite bacteremia performed worse on tests of general cognitive ability, language, academic achievement, and executive function, even when adjusting for potential confounders. Adjustment for low IQ attenuated associations between bacteremia and all dysfunctions at 10 years. Children who had suspected bacteremia did not differ appreciably from children who did not have any evidence of bacteremia. The motor domain was unaffected. Conclusions Extremely low gestational age newborns who had definite late bacteremia during postnatal weeks 2–4 are at heightened risk of neurocognitive limitations at 10 years of age.

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LP. Feeding strategies to prevent neonatal SARS-CoV-2 infection in term or late preterm babies born to mothers with confirmed COVID-19 (Protocol).

Objective: Review how specific delivery management interventions (DMI) are associated with early neonatal SARS-CoV-2 infection (ENI) and neonatal death <28 days of life (ND). Design: Systematic review and meta-analysis of individual patient-specific data from articles published 1 January 2020 - 31 December 2021 from Cochrane review databases, Medline and Google Scholar. Setting: International publications specifying DMI, ENI, and ND.​​ Patients: ​Pregnant women infected with SARS-CoV-2 and their​ infants Main outcome measures: Article inclusion criteria: 1) mothers with SARS-CoV-2 PCR positive status within 10 days before delivery or symptomatic at delivery with a positive test within 48 hours after delivery, 2) delivery method described, 3) infant SARS-CoV-2 PCR result reported. Primary outcomes were 1) ENI confirmed by positive neonatal PCR and 2) ND. Results: Among 11,075 screened publications, 117 publications containing data for 244 infants and 230 mothers were included. Maternal and infant characteristics were pooled using DerSimonian-Laird inverse variance method. Primary outcome analyses were completed using logit transformation and random effect. Heterogeneity of included studies was evaluated with I2 ​statistics.​ No routine care was described so comparison of DMI combinations to routine care was not possible. Sample size for each combination was too small to conduct any valid comparison of different DMI combinations. Conclusion: Support for specific DMI in SARS-CoV-2 infected mothers is lacking. This review highlights the need for rigorous and multinational studies on the guidelines best suited to prevent transmission from mother to neonate.

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LP. Feeding strategies to prevent neonatal SARS-CoV-2 infection in term or late preterm babies born to mothers with confirmed COVID-19 (Protocol).