INTRODUCTION Sepsis and intraventricular hemorrhage (IVH) are associated with poorer long-term neurodevelopmental outcomes in very preterm infants (VPIs), but less is known about the long-term effect of meningitis and the combined impact of both meningitis and IVH. Our objective was to examine the long-term neurodevelopmental outcomes of VPIs with late onset sepsis and meningitis, with and without IVH, in Canada. METHODS We conducted a retrospective cohort study of all infants <29 weeks GA who were admitted to 26 tertiary-level neonatal intensive care units in the Canadian Neonatal Network (CNN) and Canadian Neonatal Follow-Up Network (CNFUN) databases, from January 1, 2010, to December 31, 2016. RESULTS Of the 6,322 infants in the cohort, 4,575 had no infection, 1,590 had late onset culture-positive bloodstream infection (CPBSI) only, and 157 had late onset meningitis. There was a significant (p < 0.05) trend of increasing rates of significant neurodevelopmental delay (sNDI) when comparing infants with no infection (sNDI rate 15.0%), late onset CPBSI (sNDI rate 22.9%), and late onset meningitis (sNDI rate 32.0%), even after adjustment for infant characteristics. Similar trends were observed for neurodevelopmental impairment, cerebral palsy, and individual Bayley-III scores <85 for cognitive, language, and motor development. There was an additive effect of IVH in all infant categories, but there was no multiplicative effect between IVH and late onset meningitis. CONCLUSION There was an increasing trend of adverse neurodevelopmental outcomes when infants with no infection, late onset CPBSI and late onset meningitis are compared. IVH had an additive effect.

中文翻译：

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患有败血症、脑膜炎和脑室内出血的极早产儿的长期神经发育障碍。

引言 脓毒症和脑室内出血 (IVH) 与极早产儿 (VPI) 的长期神经发育结局较差相关，但人们对脑膜炎的长期影响以及脑膜炎和 IVH 的综合影响知之甚少。我们的目的是检查加拿大迟发性脓毒症和脑膜炎（伴或不伴 IVH）的 VPI 的长期神经发育结果。方法 我们对自 1 月 1 日起入住加拿大新生儿网络 (CNN) 和加拿大新生儿随访网络 (CNFUN) 数据库中 26 个三级新生儿重症监护病房的所有 GA ＜ 29 周的婴儿进行了回顾性队列研究。 2010 年至 2016 年 12 月 31 日。 结果 在队列中的 6,322 名婴儿中，4,575 名没有感染，1,590 名仅患有迟发性培养阳性血流感染 (CPBSI)，157 名患有迟发性脑膜炎。与无感染婴儿（sNDI 发生率 15.0%）、晚发 CPBSI（sNDI 发生率 22.9%）和晚发脑膜炎（sNDI 发生率）婴儿相比，显着神经发育迟缓（sNDI）发生率呈显着（p < 0.05）增加趋势。 32.0%），即使在调整婴儿特征后也是如此。在神经发育障碍、脑瘫以及认知、语言和运动发育方面的个体 Bayley-III 评分<85 方面也观察到了类似的趋势。IVH 在所有婴儿类别中均存在相加效应，但 IVH 与迟发性脑膜炎之间不存在相乘效应。结论 比较无感染婴儿、晚发 CPBSI 和晚发脑膜炎婴儿，不良神经发育结局呈增加趋势。IVH 具有累加效应。