Association of late-onset neonatal sepsis with late neurodevelopment in the first two years of life of preterm infants with very low birth weight

Objective to establish the influence of late-onset sepsis on neurodevelopment of preterm infants with very low birth weight (vlbw),according to the etiologic agent. method this was a cohort of newborns with birth weight < 1,500 g and gestational age less than 32 weeks,admitted to the institutional intensive care unit (icu) with up to 48 hours of life,and followed-up at the outpatient follow-up clinic for preterm infants with vlbw until 2 years of corrected age. exclusion criteria: death within the first 72 hours of life,congenital malformations and genetic syndromes,children with congenital infection by the human immunodeficiency virus (hiv),congenital infection (storch),presence of early-onset sepsis and cases with more than one pathogen growth in blood cultures. septic and non-septic infants were compared regarding neonatal outcomes and mortality. neurodevelopment was assessed using the bayley scale (bsdi-ii) at 18 to 24 months of corrected age. results 411 preterm infants with vlbw were eligible; the mean gestational age was 29 ± 2.2 weeks and mean birth weight was 1,041 ± 281grams. late-onset sepsis occurred in 94 preterm infants with vlbw (22.8%). vlbw infants with gram-positive infection showed motor deficit when compared to the non-septic group,68.8% vs. 29.3%,respectively (or 6; 1.6-21.8,p = 0.006); the cognitive development was similar between the groups. the overall mortality rate from infection was 26.7%; considering the pathogens,the rates were 18.7% for coagulase-negative staphylococcus,21.8% for gram-positive bacteria,and 50% for gram-negative bacteria and fungi. conclusion neonatal sepsis has a significant influence on late neurodevelopment at 2 years of corrected age in preterm infants with vlbw,and gram-positive infections are associated with motor deficit. © 2013 sociedade brasileira de pediatria.