Clinical Outcomes of Neonatal Meningitis in Very-Low-Birth-Weight Infants

Authors:
  • NNNancy Newman
    Nancy Newman
  • NMNori M. Minich
    Nori M. Minich
  • HTH. Gerry Taylor
    H. Gerry Taylor
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Abstract
We sought to describe the clinical presentation and consequences of meningitis among 64 very-low-birth-weight (VLBW 3, 5 protein >150 mg/dL%, and 6 glucose <30 mg/dL (1.67 mmol/L). Only 10 infants (26%) had 1 or more of these spinal fluid abnormalities. Meningitis survivors had a higher rate of major neurologic abnormality (41% vs 11%, p<0.001) and subnormal (<70) Mental Development Index (38% vs 14%, p<0.001) than nonmeningitis survivors. Impairment rates did not differ by etiologic organism. The effect of meningitis on neurologic outcome persisted even after controlling for birth weight, intraventricular hemorrhage, chronic lung disease, and social risk factors (odds ratio 2.27 [95% CI 1.02, 5.05]). We conclude that despite a sparsity of abnormal spinal fluid findings, culture-proven neonatal meningitis among VLBW infants has a detrimental effect on neurologic outcome, which persists even after controlling for other risk factors.

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