Neurocognitive impairment after neonatal sepsis: protocol for a systematic review and meta-analysis

Abstract

IntroductionThe effect of neonatal sepsis on the developing brain is not well documented. We aim to perform evidence synthesis to determine the outcome of neurodevelopmental impairment and intellectual disability among survivors of neonatal sepsis. The data gathered will inform on the long-term neurocognitive outcomes of neonates with sepsis and the measures used to document their developmental disability.Methods and analysisWe will perform a search based on the following parameters: neonates and infants less than 90 days old diagnosed with sepsis who had neurocognitive outcomes or measures of developmental disability reported. We will search PubMed, Cochrane Central, Embase and Web of Science for articles in English language published between January 2010 and December 2019. Clinical trials and observational studies will be included. Two independent reviewers will screen studies for eligibility. Data extraction will then be performed using a standardised form. The quality of evidence and risk of bias will be assessed using Cochrane Collaboration’s tool and Risk of Bias in Non-randomised Studies of Intervention (ROBINS-I). The results will be synthesised qualitatively and pooled for meta-analysis.Ethics and disseminationNo formal ethical approval is required as there is no collection of primary data. This systematic review and meta-analysis will be disseminated through conference meetings and peer-reviewed publications.PROSPERO registration numberRegistration submitted CRD42020164334

Comparison of disease burden and major risk factors of early and late-onset neonatal sepsis in China and the USA, 1990-2019

“…Third, neonatal sepsis may lead to cerebral white matter damage and increase the susceptibility of the brain to subsequent injury through a free radical attack, production of pro-in ammatory cytokines, and hypoxic-ischemic encephalopathy due to hypotension and impaired autoregulation of cerebral blood ow [24]. With the development of measures to assess and document neurocognitive outcomes in recent years, long-term follow-up of high-risk populations has intensi ed, and the consequences of disability due to neonatal sepsis have been studied [25]. To improve neurological de cits, neonatal brain development can be promoted by enhancing sensory stimulation and other measures [26].…”

Altered brain metabolite concentration and delayed neurodevelopment in preterm neonates

“…Previous studies have reported that neonatal sepsis and/or chronic lung disease could impair neurodevelopmental outcomes. 35,36 Hüppi et al demonstrated that developmental disruption and plasticity in the lungs and brain was closely associated with events inducing inflammation, oxidative stress, and endocrine disruption. 37 These events could disturb NAA production in neuronal mitochondria, 32,33 leading to reductions in tNAA concentrations in subjects with low DQ scores.…”

Clinical characteristics and laboratory test in full-term neonates with sepsis in Vietnam National Children’s Hospital (Northern Vietnam)

“…Sepsis is a life-threatening condition in response to an infectious agent, causing damage to tissues and organs. Sepsis causes serious consequences in neonates due to high rates of mortality, sequelae, and disability [17,27]. Vietnam is a country in Southeast Asia featuring some of the highest infectious disease rates in the world, including high rates of infection, disability, and mortality [22].…”