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. 2018 Feb;19(2):89-97.
doi: 10.1097/PCC.0000000000001367.

Cognitive Development One Year After Infantile Critical Pertussis

John T Berger  1 , Michele E Villalobos  2 , Amy E Clark  3 , Richard Holubkov  3 , Murray M Pollack  1 , Robert A Berg  4 , Joseph A Carcillo  5 , Heidi Dalton  6 , Rick Harrison  7 , Kathleen L Meert  8 , Christopher J L Newth  9 , Thomas P Shanley  10 , David L Wessel  1 , Kanwaljeet J S Anand  11 , Jerry J Zimmerman  12 , Ronald C Sanders Jr  13 , Teresa Liu  3 , Jeri S Burr  3 , Douglas F Willson  14 , Allan Doctor  15 , J Michael Dean  3 , Tammara L Jenkins  16 , Carol E Nicholson  16 ; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network
Affiliations

Cognitive Development One Year After Infantile Critical Pertussis

John T Berger et al. Pediatr Crit Care Med. 2018 Feb.

Abstract

Objectives: Pertussis can cause life-threatening illness in infants. Data regarding neurodevelopment after pertussis remain scant. The aim of this study was to assess cognitive development of infants with critical pertussis 1 year after PICU discharge.

Design: Prospective cohort study.

Setting: Eight hospitals comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 18 additional sites across the United States.

Patients: Eligible patients had laboratory confirmation of pertussis infection, were less than 1 year old, and were admitted to the PICU for at least 24 hours.

Interventions: The Mullen Scales of Early Learning was administered at a 1-year follow-up visit. Functional status was determined by examination and parental interview.

Measurements and main results: Of 196 eligible patients, 111 (57%) completed the Mullen Scales of Early Learning. The mean scores for visual reception, receptive language, and expressive language domains were significantly lower than the norms (p < 0.001), but not fine and gross motor domains. Forty-one patients (37%) had abnormal scores in at least one domain and 10 (9%) had an Early Learning Composite score 2 or more SDs below the population norms. Older age (p < 0.003) and Hispanic ethnicity (p < 0.008) were associated with lower mean Early Learning Composite score, but presenting symptoms and PICU course were not.

Conclusions: Infants who survive critical pertussis often have neurodevelopmental deficits. These infants may benefit from routine neurodevelopmental screening.

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Conflict of interest statement

The remaining authors have disclosed that they do not have any potential conflicts of interest.

Figures

Figure 1
Figure 1
Enrollment and Follow-up Flow Diagram.
Figure 2
Figure 2. Mullen Domain Scores
Box-and-whisker plots show summary statistics as min (with outliers depicted by filled circles), 25th percentile, median, 75th percentile, max, and mean (+). The T score is a standardized score with a population mean of 50 and standard deviation of 10. The scores for visual reception, receptive and expressive language (p<0.001) but not motor were significantly lower than the population norms.
Figure 3
Figure 3. Distribution of the Mullen Early Learning Composite Score
The Early Learning Composite is derived from the four cognitive scales (fine motor, visual reception, receptive language, and expressive language) and is normalized to have a mean of 100 and a standard deviation of 15. The mean observed in the study cohort is significantly different from the population mean (p<0.001).
See this image and copyright information in PMC

Comment in

References

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