Neurodevelopmental outcomes of very low birth weight infants with neonatal sepsis: systematic review and meta-analysis

Objective:to study the impact of neonatal sepsis on the long-term neurodevelopmental outcome in very low birth weight (vlbw) infants.study design:systematic review and meta-analysis of observational studies comparing neurodevelopmental outcomes in vlbw infants exposed to culture-proven sepsis in the neonatal period with similar infants without sepsis.result:seventeen studies involving 15 331 infants were included in the meta-analysis. sepsis in vlbw infants was associated with an increased risk of one or more long-term neurodevelopmental impairments (odds ratio (or) 2.09; 95% confidence interval (ci) 1.65 to 2.65) including cerebral palsy (cp; or 2.09; 95% ci 1.78 to 2.45). heterogeneity (i2=36.9%; p=0.06) between the studies was significant and related to variations in patient characteristics, causative pathogens and follow-up methods. sensitivity analyses based on study design, follow-up rate and year of birth were not significantly different from the overall analysis.conclusion:the meta-analysis suggests that sepsis in vlbw infants is associated with a worse neurodevelopmental outcome including higher incidence of cp.