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February 23, 2005

Neurodevelopmental Impairment and Neonatal Infections

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2005;293(8):932. doi:10.1001/jama.293.8.932-a

To the Editor: Dr Stoll and colleagues1 confirm an association between adverse neurodevelopmental outcome and infection in extremely low-birth-weight (ELBW) infants. Of note is that there was a 30% increase in both neurodevelopmental impairment and poor head growth in infants with coagulase-negative staphylococcal sepsis and those with culture-negative clinical infection. These 2 groups represented about two thirds of all episodes of proven or suspected infection, so it is important that they are included in possible therapeutic trials of anti-inflammatory agents.2 We would like to know what proportion of culture-negative clinical infection was attributed to pneumonia. It would also be valuable to know whether necrotizing enterocolitis (NEC) alone (without prior, concurrent, or subsequently proven sepsis) was associated with adverse neurodevelopmental outcome.

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