Late-onset sepsis and neurodevelopmental outcomes at age 5 among children born very preterm: the EPIPAGE-2 cohort study

OBJECTIVE: To assess the association between late-onset sepsis (LOS) and neurodevelopmental disorders (NDD) at 5 years of age among children born very preterm. METHODS: We included children from the EPIPAGE-2 cohort study, born before 32 weeks of gestation and followed at 5 years. LOS was defined as one positive blood culture after 72 hours of life, associated with antibiotic therapy ≥5 days. At 5 years, NDD were evaluated as a composite outcome including cerebral palsy, neurosensory impairment and/or coordination, cognitive and behavioural disorders. NDD were categorised as: none, mild or moderate-to-severe disorders. We used multivariable multinomial regressions after multiple imputations of missing data to assess the association between LOS and NDD at 5 years. RESULTS: Among the 3186 children born very preterm, 697 (20.6%) had at least one episode of LOS and 1927 (60.5%) had a complete assessment at 5 years. Among children who had an LOS, 42.2% had no NDD, 38.2% had mild NDD and 19.6% had moderate-to-severe NDD. The proportion of children with three episodes of LOS was higher in the mild NDD group and in the moderate to severe NDD group than in the none NDD group (1.3% vs 0.6% and 2.8 vs 0.6%, respectively). No association was found between the occurrence of at least one episode of LOS and NDD (mild NDD adjusted OR (aOR) 1.06 (95% CI 0.82 to 1.36); moderate-to-severe NDD aOR 1.18 (95% CI 0.90 to 1.55)). CONCLUSION: We found no significant association between LOS and mild, moderate or severe NDD at five in children born very preterm.