Abstract from the original paper:
Aims: The study investigated a putative association between early-onset-sepsis (EOS) and poor neurodevelopmental outcomes at 2 years corrected age in very low birth weight infants.
Methods: This was a single-center cohort study on infants weighing less than 1500g with a gestational age below 35 weeks at birth born between 2008 and 2011. Neurodevelopmental outcomes were assessed at follow-up with the Bayley Scales of Infant Development-II. EOS was defined as either culture-proven EOS or clinical EOS using blood culture, CrP levels, and clinical symptoms and treatment. Neurodevelopmental impairment (NDI) was defined as one or more of the following: Mental Developmental Index (MDI) and/or Psychomotor Developmental Index (PDI) scores lower than 70; presence of cerebral palsy.
Results: Of 405 eligible newborns in the study period 166 were included. Two had culture-proven and 29 clinical EOS. Median MDI scores in patients with EOS were 96 (IQR: 86–106) and in the control group 94 (84–106, p=0.77). PDI scores in patients with EOS were 96 (86–106) and in the control group 99,5 (92–103, p=0.03). Of infected patients 7/31 (24%) showed NDI as defined, whereas only 11/135 (8%) showed NDI in the control group (OR 3.3, p=0.03). Multiple regression analyses identified chorioamnionitis and poor CRIB-Scores as individual risk factors for MDI or PDI values <70.
Conclusion: In our study, EOS among VLBW-infants significantly impaired the neurodevelopment at two years corrected age. As shown in previous reports infection continues to be a problem and strategies for a reduction need further improvement.:Table of contents
I. PRELIMINARY REMARKS 1
i. Tables and Figures 2
a. Figures and subtitles 2
b. Tables and titles 2
ii. Abbreviations 3
iii. Bibliographic Summary 4
1 Introduction 5
1.1. Early-onset-sepsis 5
1.1.1 Epidemiology 5
1.1.2 Pathogenesis 7
1.1.3 Pathogens causing EOS 7
1.1.4 Risk factors of EOS 8
1.1.5 Diagnosis of EOS 9
1.1.6 Treatment of EOS 10
1.2 Intrauterine infection 11
1.3 Neurodevelopment of neonates and brain injury 12
1.4 Rationale and objectives of our study 14
2 Original Publication 16
3 Summary 30
4 References 34
5 German Supplement 39
5.1. Darstellung des eigenen Beitrages 39
5.2. Erklärung über die eigenständige Abfassung der Arbeit 40
5.3. Curriculum vitae 41
5.4. Danksagung 42
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:85958 |
| Date | 12 June 2023 |
| Creators | Ortgies, Tjark |
| Contributors | Universität Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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