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Meta-Analysis
. 2024 Aug 7;24(1):505.
doi: 10.1186/s12887-024-04977-8.

Impact of neonatal sepsis on neurocognitive outcomes: a systematic review and meta-analysis

Wei Jie Ong #  1 , Jun Jie Benjamin Seng #  2   3   4 , Beijun Yap  1 , George He  5 , Nooriyah Aliasgar Moochhala  5 , Chen Lin Ng  1 , Rehena Ganguly  6 , Jan Hau Lee  7 , Shu-Ling Chong  8
Affiliations
Meta-Analysis

Impact of neonatal sepsis on neurocognitive outcomes: a systematic review and meta-analysis

Wei Jie Ong et al. BMC Pediatr. .

Abstract

Introduction: Sepsis is associated with neurocognitive impairment among preterm neonates but less is known about term neonates with sepsis. This systematic review and meta-analysis aims to provide an update of neurocognitive outcomes including cognitive delay, visual impairment, auditory impairment, and cerebral palsy, among neonates with sepsis.

Methods: We performed a systematic review of PubMed, Embase, CENTRAL and Web of Science for eligible studies published between January 2011 and March 2023. We included case-control, cohort studies and cross-sectional studies. Case reports and articles not in English language were excluded. Using the adjusted estimates, we performed random effects model meta-analysis to evaluate the risk of developing neurocognitive impairment among neonates with sepsis.

Results: Of 7,909 studies, 24 studies (n = 121,645) were included. Majority of studies were conducted in the United States (n = 7, 29.2%), and all studies were performed among neonates. 17 (70.8%) studies provided follow-up till 30 months. Sepsis was associated with increased risk of cognitive delay [adjusted odds ratio, aOR 1.14 (95% CI: 1.01-1.28)], visual impairment [aOR 2.57 (95%CI: 1.14- 5.82)], hearing impairment [aOR 1.70 (95% CI: 1.02-2.81)] and cerebral palsy [aOR 2.48 (95% CI: 1.03-5.99)].

Conclusion: Neonates surviving sepsis are at a higher risk of poorer neurodevelopment. Current evidence is limited by significant heterogeneity across studies, lack of data related to long-term neurodevelopmental outcomes and term infants.

Keywords: Infantile sepsis; Neonatal sepsis; Neurocognitive outcomes; Sepsis; Systematic review.

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Conflict of interest statement

No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of the study selection process for search
Fig. 2
Fig. 2
World map depicting distribution of studies that evaluate neurocognitive outcomes in infantile and neonatal sepsis
Fig. 3
Fig. 3
A Forest plot on adjusted odds ratios for neurocognitive outcomes related to MDI, PDI, visual impairment, hearing impairment and cerebral palsy. B Forest plot on unadjusted odds ratios for neurocognitive outcomes related to MDI, PDI, visual impairment, hearing impairment and cerebral palsy. Legend: MDI: Mental Developmental Index; PDI: Psychomotor Developmental Index. Foot note: Mild MDI or PDI: < 85 or < 80; Moderate MDI or PDI < 70; Severe MDI or PDI < 55
See this image and copyright information in PMC

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