Neonatal sepsis as a risk factor for neurodevelopmental changes in preterm infants with very low birth weight

Ferreira, Rachel C.; Mello, Rosane Reis de; Silva, Kátia S.

doi:10.1016/j.jped.2013.09.006

Cited by 59 publications

(38 citation statements)

References 25 publications

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“…Likewise, the higher risk of impairments in children admitted to the NSCU compared to those admitted only to the KCU can be explained by the fact that children admitted to the NSCU represent a higher risk group, either because of a lower weight at birth or because of associated morbidities, such as intrapartum events or neonatal infection. Neonatal sepsis, for instance, has been found to be an independent predictor for neuro-motor developmental impairment in pre-term infants [21]. Figure 3 (a-c) Nutritional status of low-birthweight neonates 2 years after discharge from a neonatal special care unit, Kabezi district hospital, Burundi (January-December 2012).…”

Section: Discussionmentioning

confidence: 99%

How do low‐birthweight neonates fare 2 years after discharge from a low‐technology neonatal care unit in a rural district hospital in Burundi?

Boogaard

Zuniga

Manzi

et al. 2017

Tropical Med Int Health

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Abstractobjectives As neonatal care is being scaled up in economically poor settings, there is a need to know more on post-hospital discharge and longer-term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in lowbirthweight neonates (LBW, <2500 g). Getting a better handle on these parameters might justify and guide support interventions. Two years after hospital discharge, we thus assessed: mortality, developmental impairments and nutritional status of LBW children.methods Household survey of LBW neonates discharged from a neonatal special care unit in Rural Burundi between January and December 2012.results Of 146 LBW neonates, 23% could not be traced and 4% had died. Of the remaining 107 children (median age = 27 months), at least one developmental impairment was found in 27%, with 8% having at least five impairments. Main impairments included delays in motor development (17%) and in learning and speech (12%). Compared to LBW children (n = 100), very-low-birthweight (VLBW, <1500 g, n = 7) children had a significantly higher risk of impairments (intellectual -P = 0.001), needing constant supervision and creating a household burden (P = 0.009). Of all children (n-107), 18% were acutely malnourished, with a 3½ times higher risk in VLBWs (P = 0.02).conclusions Reassuringly, most children were thriving 2 years after discharge. However, malnutrition was prevalent and one in three manifested developmental impairments (particularly VLBWs) echoing the need for support programmes. A considerable proportion of children could not be traced, and this emphasises the need for follow-up systems post-discharge.

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Section: Discussionmentioning

confidence: 99%

How do low‐birthweight neonates fare 2 years after discharge from a low‐technology neonatal care unit in a rural district hospital in Burundi?

Boogaard

Zuniga

Manzi

et al. 2017

Tropical Med Int Health

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“…Neonatal infections cause a significant proportion of death in the first week of life (Chan et al, 2015) and account for approximately one third of all neonatal deaths (Black et al, 2010), while those neonates that survive neonatal infection are now recognized to have increased vulnerability to short- and long-term neurodevelopmental disability (Dammann et al, 2002; Ferreira et al, 2014; Stoll et al, 2002). At birth, the neonate must transition from the sterile environment of the mother to an environment filled with pathogens, microbes, and toxins, and must also begin robust, rhythmic breathing.…”

Section: Conclusion and Clinical Relevancementioning

confidence: 99%

The impact of inflammation on respiratory plasticity

Hocker

Stokes

Powell

et al. 2017

Experimental Neurology

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Breathing is a vital homeostatic behavior and must be precisely regulated throughout life. Clinical conditions commonly associated with inflammation, undermine respiratory function may involve plasticity in respiratory control circuits to compensate and maintain adequate ventilation. Alternatively, other clinical conditions may evoke maladaptive plasticity. Yet, we have only recently begun to understand the effects of inflammation on respiratory plasticity. Here we review some of common models used to investigate the effects of inflammation and discuss the impact of inflammation on nociception, chemosensory plasticity, medullary respiratory centers, motor plasticity in motor neurons and respiratory frequency, and adaptation to high altitude. We provide new data suggesting glial cells contribute to CNS inflammatory gene expression after 24 hours of sustained hypoxia and inflammation induced by 8 hours of intermittent hypoxia inhibits long-term facilitation of respiratory frequency. We also discuss how inflammation can have opposite effects on the capacity for plasticity, whereby it is necessary for increases in the hypoxic ventilatory response with sustained hypoxia but inhibits phrenic long term facilitation after intermittent hypoxia. This review highlights gaps in our knowledge about the effects of inflammation on respiratory control (development, age, and sex differences). In summary, data to date suggest plasticity can be either adaptive or maladaptive and understanding how inflammation alters the respiratory system is crucial for development of better therapeutic interventions to promote breathing and for utilization of plasticity as a clinical treatment.

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“…Results similar to this were also observed in neonates with low birth weight. 13 Fever was found in 81.4% of patients in weight group >3 kilograms compare to only 46.9% patients in weight group ≤ 3 kilograms. This difference was statistically significant at p <0.05.…”

Section: Discussionmentioning

confidence: 91%

C-Reactive Protein : An Important Diagnostic Tool in Neonatal Sepsis

Panchal

Patel²

2018

APALM

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Background: Global burden of pediatric mortality during the very first month of life is around four million per year. In developing country like India, neonatal mortality is as high as one fourth (25%) of the global burden means around one million per year. Among the various common causes, infection or sepsis alone contributes for almost 30-40% of total neonatal deaths. The study is aimed to determine the effectiveness of C-reactive protein (CRP) as a diagnostic tool in neonatal sepsis. Materials and Methods:This is a cohort prospective study. Study included total 123 patients considering inclusion and exclusion criteria. Blood samples were taken from all the patients for blood culture and CRP measurements. Results of blood culture and CRP were recorded and statistical analysis was performed by GraphPad Instat Demo. Results:Out of 123 patients included in the study blood culture was positive in 71 (57.72%) patients and CRP was raised in 72 (58.54%) patients. Sensitivity, specificity, positive predictive value and negative predictive value for CRP were found to be 98.59%, 96.15%, 97.23% and 98.04% respectively.Conclusion: C-reactive protein has high sensitivity and specificity with good positive predictive value and negative predictive value for establishing diagnosis of neonatal sepsis and results with CRP are comparable to those with blood culture.

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Neonatal sepsis as a risk factor for neurodevelopmental changes in preterm infants with very low birth weight

Abstract: neonatal sepsis was an independent risk factor for neuromotor development impairment at 12 months of corrected age, but not for mental development impairment.

Cited by 59 publications

References 25 publications

How do low‐birthweight neonates fare 2 years after discharge from a low‐technology neonatal care unit in a rural district hospital in Burundi?

How do low‐birthweight neonates fare 2 years after discharge from a low‐technology neonatal care unit in a rural district hospital in Burundi?

The impact of inflammation on respiratory plasticity

C-Reactive Protein : An Important Diagnostic Tool in Neonatal Sepsis

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