Neonatal Infectious Diseases/Immunology
Neonatal Infectious Diseases/Immunology 2
Renato S. Procianoy, MD, PhD (he/him/his)
Full Professor
Universidade Federal do Rio Grande do Sul and Hospital de clínicas de Porto Alegre
Porto Alegre, Rio Grande do Sul, Brazil
To evaluate the impact of antibiotic use in the first 3 days of life in neonates without proven sepsis on child neurodevelopment in the first 12 to 24 months of corrected age.
Design/Methods: Preterms with gestational age less than 34 weeks and presumed sepsis born from 2014 to 2021, who underwent follow-up of at least 1 year of corrected age, were retrospectively analyzed. Patients were allocated into two groups according to antibiotic use: one group received empirical antibiotic therapy and the other group did not receive antibiotics. Preterms with confirmed infections or malformations were excluded. BSID-III results were compared in both groups, and a multivariable model was used to control for gestational age. Institutional Ethical Committee approved.
Results:
A total of 215 preterm infants (123 received antibiotics, 92 did not) were included with Birth Weight 1227± 365grams and Gestational Age 29.6± 2.22 weeks. Patients who received antibiotics had lower scores on the BSID-III subscales for cognitive (91.9 vs. 98.3, p = 0.002), language (90.3 vs. 94.7, p = 0.034); and motor (89.5 vs. 97.4, p < 0.001) development than those who did not. However, there was a significant difference in the gestational age (28.8 ± 2.27 weeks in the antibiotics group vs. 30.8 ± 1.6 weeks in no antibiotics group, p < 0.001). After controlling for gestational age, infants who received antibiotics had more risk for moderate to severe neurodevelopmental impairment in cognitive (OR 2.25, 0.49 - 15.96), language (OR 1.55, 0.46 - 6.13), and motor (OR 3.30, 0.80 - 22.43) domains.
Conclusion(s):
The use of antibiotics in the first 72 hours in preterm infants with presumed sepsis has a negative impact on cognitive, language, and motor neurodevelopmental outcomes.