Neonatal infection and long-term neurodevelopmental outcome in the preterm infant

Purpose of review The relationship between infection, the inflammatory response and adverse neurodevelopment outcome in preterm infants is slowly being elucidated. The developing brain, particularly the periventicular white matter, is vulnerable to cytotoxic and hypoxic/ishemic injury, which places these infants at increased risk for abnormal cognitive and motor functioning. This review summarizes current data evaluating associations between infection and neurodevelopment outcome in the preterm infant. Recent findings Preterm infants are at risk for intrauterine and postnatal infections. Recent studies have linked infection/inflammation associated with chorioamnionitis, sepsis and necrotizing enterocolitis with adverse neurodevelopment outcome and impaired growth in preterm infants. Investigators have also shown associations between infection and brain injury, including severe intraventicular hemorrhage and periventicular leukomalacia. Very-low-birth-weight preterm infants are at substantial risk for neonatal infection, with associated morbidity and mortality. It is postulated that exposure of the preterm brain to inflammatory mediators during infectious episodes contributes to brain injury and poor developmental outcome. Summary Enhanced understanding of the interaction of infection, inflammation and brain injury will be critical to developing strategies to improve neurodevelopmental outcome in preterm infants.