What is the prognosis of neonatal sepsis?

Updated: Jun 13, 2019
  • Author: Nathan S Gollehon, MD, FAAP; Chief Editor: Muhammad Aslam, MD  more...
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With early diagnosis and treatment of neonatal sepsis, most term infants will not experience associated long-term health problems. However, if early signs or risk factors are missed, mortality increases. Residual neurologic damage occurs in 15%-30% of neonates with septic meningitis.

Mortality from neonatal sepsis may be as high as 50% for infants who are not treated. Infection is a major cause of mortality during the first month of life, contributing to 13%-15% of all neonatal deaths. Low birth weight and gram-negative infection are associated with worse outcomes. [27] Neonatal meningitis occurs in 2-4 cases per 10,000 live births and contributes significantly to mortality from neonatal sepsis; it is responsible for 4% of all neonatal deaths.

In preterm infants who have had sepsis, impaired neurodevelopment is a concern. [28] Proinflammatory molecules may negatively affect brain development in this patient population. In a large study of 6093 premature infants who weighed less than 1000 g at birth, preterm infants with sepsis who did not have meningitis had higher rates of cerebral palsy (odds ratio [OR] 1.4-1.7), developmental delay (OR 1.3-1.6), and vision impairment (OR 1.3-2.2) as well as other neurodevelopmental disabilities than infants who did not have sepsis. [29, 30]

Infants with meningitis may acquire hydrocephalus or periventricular leukomalacia. They may also have complications associated with the use of aminoglycosides, such as hearing loss or nephrotoxicity.

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