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- Ayoub Mitha
- Neonatal Unit Hôpital Jeanne de Flandre, Lille, France;
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- Laurence Foix-L’Hélias
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S953, Epidemiological Research Unit on Perinatal Health and Women's and Children’s Health, Paris, France;
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- Catherine Arnaud
- Institut National de la Santé et de la Recherche Médicale, Toulouse, France;
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- Stéphane Marret
- Department of Neonatal Medicine, Rouen University Hospital, Rouen, France;
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- Rachel Vieux
- Neonatal Unit Nancy University Hospital, Nancy, France;
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- Yannick Aujard
- NICU, Hopital Robert Debré, Assistance Publique Hopitaux de Paris et Université Paris Diderot, Paris, France;
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- Gérard Thiriez
- Pediatrics Department, Besançon University Hospital, Franche-Comté University, Besançon, France;
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- Béatrice Larroque
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S953, Epidemiological Research Unit on Perinatal Health and Women's and Children’s Health, Paris, France;
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- Gilles Cambonie
- NICU and PICU Montpellier University Hospital, Hopital Arnaud de Villeneuve, Montpellier, France;
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- Antoine Burguet
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S953, Epidemiological Research Unit on Perinatal Health and Women's and Children’s Health, Paris, France;
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- Pascal Boileau
- Neonatal Unit, Centre Hospitalier Intercommunal Créteil, Université de Versailles Saint-Quentin, Poissy, France;
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- Jean Christophe Rozé
- Department of Neonatology, Nantes University, Nantes, France;
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- Monique Kaminski
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S953, Epidemiological Research Unit on Perinatal Health and Women's and Children’s Health, Paris, France;
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- Patrick Truffert
- Neonatal Unit Hôpital Jeanne de Flandre, Lille, France;
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- Pierre-Yves Ancel
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche S953, Epidemiological Research Unit on Perinatal Health and Women's and Children’s Health, Paris, France;
説明
<jats:sec><jats:title>OBJECTIVE:</jats:title><jats:p>To determine whether neonatal infections are associated with a higher risk of adverse neurodevelopment at 5 years of age in a population-based cohort of very preterm children.</jats:p></jats:sec><jats:sec><jats:title>METHODS:</jats:title><jats:p>We included all live births between 22 and 32 weeks of gestation, from 9 regions in France, in 1997 (EPIPAGE study). Of the 2665 live births, 2277 were eligible for a follow-up evaluation at 5 years of age: 1769 had a medical examination and 1495 underwent cognitive assessment. Cerebral palsy and cognitive impairment were studied as a function of early-onset sepsis (EOS) and late-onset sepsis (LOS), after adjustment for potential confounding factors, in multivariate logistic regression models.</jats:p></jats:sec><jats:sec><jats:title>RESULTS:</jats:title><jats:p>A total of 139 (5%) of the 2665 live births included in the study presented with EOS alone (without associated LOS), 752 (28%) had LOS alone (without associated EOS), and 64 (2%) displayed both EOS and LOS. At 5 years of age, the frequency of cerebral palsy was 9% (157 of 1769) and that of cognitive impairment was 12% (177 of 1495). The frequency of cerebral palsy was higher in infants with isolated EOS (odds ratio [OR]: 1.70 [95% confidence interval (CI): 0.84−3.45]) or isolated LOS (OR: 1.71 [95% CI: 1.14−2.56]) than in uninfected infants, and this risk was even higher in cases of combined EOS and LOS (OR: 2.33 [95% CI: 1.02−5.33]). There was no association between neonatal infection and cognitive impairment.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS:</jats:title><jats:p>Neonatal infections in these very preterm infants were associated with a higher risk of cerebral palsy at the age of 5 years, particularly in infants presenting with both EOS and LOS.</jats:p></jats:sec>
収録刊行物
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- Pediatrics
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Pediatrics 132 (2), e372-e380, 2013-08-01
American Academy of Pediatrics (AAP)