Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis
Background: Systemic infection is a major upstream mechanism for white matter abnormality (WMA). Our aim was to evaluate the risk factors for moderate-to-severe WMA in extremely premature infants (gestational age < 28 weeks) with neonatal sepsis. Methods: Extremely premature infants with culture-...
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Elsevier
2018-02-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957216301462 |
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| author | Ju Sun Heo Ee-Kyung Kim Young Hun Choi Seung Han Shin Jin A Sohn Jung-Eun Cheon Han-Suk Kim |
| author_facet | Ju Sun Heo Ee-Kyung Kim Young Hun Choi Seung Han Shin Jin A Sohn Jung-Eun Cheon Han-Suk Kim |
| author_sort | Ju Sun Heo |
| collection | DOAJ |
| description | Background: Systemic infection is a major upstream mechanism for white matter abnormality (WMA). Our aim was to evaluate the risk factors for moderate-to-severe WMA in extremely premature infants (gestational age < 28 weeks) with neonatal sepsis. Methods: Extremely premature infants with culture-proven sepsis between 2006 and 2015 in a tertiary neonatal intensive care unit were classified as having none-to-mild or moderate-to-severe WMA based on WM scores of brain magnetic resonance imaging at the term-equivalent age. Various risk factors for WMA were analyzed. Results: Sixty-three infants (87.5%) had none-to-mild WMA, and nine infants (12.5%) had moderate-to-severe WMA. Multivariate logistic regression analysis revealed that postmenstrual age (PMA) at sepsis diagnosis (OR: 0.640, 95% CI: 0.435–0.941, p = 0.023) and PMA at sepsis diagnosis <28 weeks (OR: 9.232, 95% CI: 1.020–83.590, p = 0.048) were independently associated with moderate-to-severe WMA. PMA at sepsis diagnosis had a significant negative correlation with WM scores (r = −0.243, p = 0.039). Conclusion: PMA at sepsis diagnosis might be an important risk factor for moderate-to-severe WMA in extremely premature infants with postnatal sepsis, especially before PMA 28 weeks. Infants who suffer from sepsis before PMA 28 weeks might need additional therapy for neuroprotection. |
| format | Article |
| id | doaj-art-b8c0654e8e8e4e7c806048c0816f1834 |
| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2018-02-01 |
| publisher | Elsevier |
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| series | Pediatrics and Neonatology |
| spelling | doaj-art-b8c0654e8e8e4e7c806048c0816f18342025-08-20T02:19:07ZengElsevierPediatrics and Neonatology1875-95722018-02-01591778410.1016/j.pedneo.2017.07.008Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsisJu Sun Heo0Ee-Kyung Kim1Young Hun Choi2Seung Han Shin3Jin A Sohn4Jung-Eun Cheon5Han-Suk Kim6Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea; Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, South KoreaDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea; Corresponding author. Department of Pediatrics, Seoul National University College of Medicine, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, South Korea. Fax: +82 2 743 3455.Department of Radiology, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Radiology, Seoul National University College of Medicine, Seoul, South KoreaDepartment of Pediatrics, Seoul National University College of Medicine, Seoul, South KoreaBackground: Systemic infection is a major upstream mechanism for white matter abnormality (WMA). Our aim was to evaluate the risk factors for moderate-to-severe WMA in extremely premature infants (gestational age < 28 weeks) with neonatal sepsis. Methods: Extremely premature infants with culture-proven sepsis between 2006 and 2015 in a tertiary neonatal intensive care unit were classified as having none-to-mild or moderate-to-severe WMA based on WM scores of brain magnetic resonance imaging at the term-equivalent age. Various risk factors for WMA were analyzed. Results: Sixty-three infants (87.5%) had none-to-mild WMA, and nine infants (12.5%) had moderate-to-severe WMA. Multivariate logistic regression analysis revealed that postmenstrual age (PMA) at sepsis diagnosis (OR: 0.640, 95% CI: 0.435–0.941, p = 0.023) and PMA at sepsis diagnosis <28 weeks (OR: 9.232, 95% CI: 1.020–83.590, p = 0.048) were independently associated with moderate-to-severe WMA. PMA at sepsis diagnosis had a significant negative correlation with WM scores (r = −0.243, p = 0.039). Conclusion: PMA at sepsis diagnosis might be an important risk factor for moderate-to-severe WMA in extremely premature infants with postnatal sepsis, especially before PMA 28 weeks. Infants who suffer from sepsis before PMA 28 weeks might need additional therapy for neuroprotection.http://www.sciencedirect.com/science/article/pii/S1875957216301462infantextremely prematuresepsiswhite matter |
| spellingShingle | Ju Sun Heo Ee-Kyung Kim Young Hun Choi Seung Han Shin Jin A Sohn Jung-Eun Cheon Han-Suk Kim Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis Pediatrics and Neonatology infant extremely premature sepsis white matter |
| title | Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis |
| title_full | Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis |
| title_fullStr | Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis |
| title_full_unstemmed | Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis |
| title_short | Timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis |
| title_sort | timing of sepsis is an important risk factor for white matter abnormality in extremely premature infants with sepsis |
| topic | infant extremely premature sepsis white matter |
| url | http://www.sciencedirect.com/science/article/pii/S1875957216301462 |
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