Cognitive Development One Year After Infantile Critical Pertussis

Berger, J. T.; Villalobos, M. E.; Clark, A. E.; Holubkov, R.; Pollack, M. M.; Berg, R. A.; Carcillo, J. A.; Dalton, H.; Harrison, R.; Meert, K. L.; Newth, C. J. L.; Shanley, T. P.; Wessel, D. L.; Anand, K. J. S.; Zimmerman, J. J.; Sanders, R. C., Jr.; Liu, T.; Burr, J. S.; Willson, D. F.; Doctor, A.; Dean, J. M.; Jenkins, T. L.; Nicholson, C. E.

Pediatr Crit Care Med. 2017 Nov 9; 19(2):89-97

Abstract

OBJECTIVES: Pertussis can cause life-threatening illness in infants. Data regarding neurodevelopment after pertussis remain scant. The aim of this study was to assess cognitive development of infants with critical pertussis 1 year after PICU discharge. DESIGN: Prospective cohort study. SETTING: Eight hospitals comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 18 additional sites across the United States. PATIENTS: Eligible patients had laboratory confirmation of pertussis infection, were less than 1 year old, and were admitted to the PICU for at least 24 hours. INTERVENTIONS: The Mullen Scales of Early Learning was administered at a 1-year follow-up visit. Functional status was determined by examination and parental interview. MEASUREMENTS AND MAIN RESULTS: Of 196 eligible patients, 111 (57%) completed the Mullen Scales of Early Learning. The mean scores for visual reception, receptive language, and expressive language domains were significantly lower than the norms (p < 0.001), but not fine and gross motor domains. Forty-one patients (37%) had abnormal scores in at least one domain and 10 (9%) had an Early Learning Composite score 2 or more SDs below the population norms. Older age (p < 0.003) and Hispanic ethnicity (p < 0.008) were associated with lower mean Early Learning Composite score, but presenting symptoms and PICU course were not. CONCLUSIONS: Infants who survive critical pertussis often have neurodevelopmental deficits. These infants may benefit from routine neurodevelopmental screening.

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