Risk factors for infection and outcomes in infants with neonatal encephalopathy: a cohort study

Odd, David ORCID: https://orcid.org/0000-0002-6416-4966, Sabir, Hemmen, Jones, Simon A. ORCID: https://orcid.org/0000-0001-7297-9711, Gale, Chris and Chakkarapani, Ela 2024. Risk factors for infection and outcomes in infants with neonatal encephalopathy: a cohort study. Pediatric Research 10.1038/s41390-024-03157-9

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Abstract

Background To determine the association between early infection risk factors and short-term outcomes in infants with neonatal encephalopathy following perinatal asphyxia (NE). Methods A retrospective population-based cohort study utilizing the National Neonatal Research Database that included infants with NE admitted to neonatal units in England and Wales, Jan 2008–Feb 2018. Exposure: one or more of rupture of membranes >18 h, maternal group B streptococcus colonization, chorioamnionitis, maternal pyrexia or antepartum antibiotics. Primary outcome: death or nasogastric feeds/nil by mouth (NG/NBM) at discharge. Secondary outcomes: organ dysfunction; length of stay; intraventricular hemorrhage; antiseizure medications use. Results 998 (13.7%) out of 7265 NE infants had exposure to early infection risk factors. Primary outcome (20.3% vs. 23.1%, OR 0.87 (95% CI 0.71–1.08), p = 0.22), death (12.8% vs. 14.0%, p = 0.32) and NG/NBM (17.4% vs. 19.9%. p = 0.07) did not differ between the exposed and unexposed group. Time to full sucking feeds (OR 0.81 (0.69–0.95)), duration (OR 0.82 (0.71–0.95)) and the number of antiseizure medications (OR 0.84 (0.72–0.98)) were lower in exposed than unexposed infants after adjusting for confounders. Therapeutic hypothermia did not alter the results. Conclusions Infants with NE exposed to risk factors for early-onset infection did not have worse short-term adverse outcomes.

Item Type:	Article
Date Type:	Published Online
Status:	In Press
Schools:	Medicine
Publisher:	Springer Nature
ISSN:	0031-3998
Date of First Compliant Deposit:	16 May 2024
Date of Acceptance:	2 March 2024
Last Modified:	22 May 2024 09:15
URI:	https://orca.cardiff.ac.uk/id/eprint/168981

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