Association of Abnormal Cerebral Perfusion in Very Preterm Infants With Late-Onset Sepsis and Neurodevelopmental Outcomes at 2 Years of Age: A Prospective Cohort Study Using Arterial Spin Labeling.

BACKGROUND

To assess cerebral blood flow (CBF) changes in very preterm infants with late-onset sepsis (LOS) using arterial spin labeling and their association with 2 years' corrected-age neurodevelopment.

METHODS

Fifty-six infants born at <32 weeks' gestation (LOS, n = 20; non-LOS, n = 36) underwent arterial spin labeling magnetic resonance imaging before discharge and Ages & Stages Questionnaires, Third Edition assessment at 2 years' corrected age. Voxel-wise CBF comparisons used family-wise error correction. Principal component analysis summarized regional CBF, and adjusted interaction models with simple-slope analyses evaluated CBF-development associations.

RESULTS

LOS infants exhibited lower CBF in the right superior and inferior orbitofrontal cortex, bilateral olfactory cortex, bilateral gyrus rectus, and left caudate nucleus (PFWE<0.05). Impairments were more prevalent in communication and personal-social domains (P < 0.05). The PC1 × LOS interaction was significant for personal-social scores (β = 7.19, 95% confidence interval 1.58 to 12.80; PFDR = 0.026), but not communication (PFDR = 0.317). The PC1 slope was positive in LOS infants but not statistically significant in non-LOS infants. Only the right gyrus rectus interaction survived regional correction (β = 7.96, 95% confidence interval 2.64-13.28; PFDR = 0.029).

CONCLUSIONS

LOS was associated with lower regional CBF, and associations of composite and right gyrus rectus perfusion with personal-social scores differed by LOS status, with positive associations among LOS infants.