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Neonatal Follow-up

NICU Follow Up and Neurodevelopment 3: Impact of the Prenatal Environment on Development and Outcomes

231 - Fungal infection and neurodevelopmental outcomes at 18-30 months in preterm infants

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 231
Publication Number: 231.143

Qi Zhou, Children's Hospital of Fudan University, Shanghai, Shanghai, China (People's Republic); Edmond N. Kelly, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Thuy Mai Luu, Centre Hospitalier Universitaire Sainte-Justine, Montreal, PQ, Canada; Xiang Y. Ye, Dept of Biostatistics, Princess Margaret Cancer Center, Toronto, ON, Canada; Joseph Ting, University of Alberta Faculty of Medicine and Dentistry, Edmonton, AB, Canada; Prakesh S. Shah, Mount Sinai Hospital, Toronto, ON, Canada; Shoo K. Lee, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada

Presenting Author(s)

Qi Zhou (she/her/hers)

Neonatology
Children's Hospital of Fudan University
Shanghai, Shanghai, China (People's Republic)

Background: Invasive fungal infection (IFI) is associated with significant mortality and morbidity among preterm infants but there has been no population-based study of long-term neurodevelopmental outcomes.

Objective:

The objective of this study was to examine population-based incidence trends as well as mortality, short term in-hospital morbidity and long-term neurodevelopmental outcomes among preterm infants with IFI, non-IFI and no infections in Canada.

Design/Methods:

We conducted a retrospective cohort study of 8408 infants born at < 29 weeks gestational age (GA), admitted to Canadian Neonatal Network neonatal intensive care units (NICU) from April 2009 to Dec 2017, and followed up at 18-30 months corrected age (CA) in Canadian Neonatal Follow-Up Network clinics. We compared mortality, long term neurodevelopmental outcomes and short term in-hospital morbidity among 3 groups of infants (IFI, non-IFI, and no infections).

Results: The incidence of IFI was 1.3%, non-IFI 26.9% and no infections 71.7%. IFI incidence varied between 0.93-1.94% across the study period with no significant trend over time. Infants of higher gestational age were significantly (p< 0.01) less likely to have IFI. Among infants with no infection, non-IFI and IFI, the incidence of the significant neurodevelopmental impairment (sNDI) was 14.84%, 21.63% and 44.26% respectively, while mortality was 22.25%, 25.35% and 50% respectively. Even after risk adjustment for confounders (GA, Score for Neonatal Acute Physiology Version II, ruptured membranes >24 hours, maternal antibiotic treatment, antenatal steroid use, cesarean section), infants with IFI had significantly higher odds of sNDI than non-IFI (aOR 2.19; 95%CI1.23,3.91) or no infections (aOR 2.97; 95% CI 1.55,5.71).

Conclusion(s):

Preterm infants with invasive fungal infections have significantly higher incidence of mortality and adverse neurodevelopmental outcomes than those with non-invasive fungal infections and no infections.