Abstract:
Background: Neonatal sepsis is a major health concern in low- and middle-income countries like Nepal, with lasting implications beyond immediate survival. This study investigates the association between neonatal sepsis and neurodevelopmental outcomes cognitive, motor, and behavioral in early childhood. It highlights the developmental progress of survivors, underlying pathophysiological mechanisms, and the need for early intervention. Emphasizing integrated care models, including early detection, caregiver support, and multidisciplinary follow-up, the study advocates for improved strategies and policies to reduce long-term impairments and enhance quality of life in resource-limited settings.
Methods: This is an ongoing prospective cohort study involving infants with both culture- positive and culture-negative sepsis, recruited from two level III Neonatal Intensive Care Units (NICUs) and tertiary care centers in Nepal. To date, 395 participants have been enrolled, with 241 completing the 6-month developmental follow-up. The cohort includes a mix of family types (2.8% extended, 54.97% joint, and 42.3% nuclear families) and varying maternal education levels (14.7% with graduate or postgraduate degrees, 9.1% illiterate). Key prenatal factors include infections in 16% of cases, intrauterine growth restriction (IUGR) in 22.3%, and fetal distress in 30.1%.
Findings till Date: Preliminary data reveal that 65.1% of blood cultures were positive for neonatal sepsis, and 54.2% of infants required assisted ventilation. Developmental assessments indicate that 21.1% of infants exhibited motor delays (15.3% mild, 2.9% moderate, 2.9% severe), and 17.7% showed mental delays (11.2% mild, 4.1% moderate, 2.4% severe). Overall, 26.5% of infants experienced either motor or mental delays, with 12.8% displaying both types of delays. These findings highlight significant developmental challenges faced by infants with neonatal sepsis.
Future Plans: The study will continue to monitor developmental outcomes as participants reach their first year of life, aiming to further elucidate the predictors of neurodevelopmental delays. The research will also explore the impact of clinical, socioeconomic, and demographic factors on developmental outcomes. By identifying these predictors, the study aims to enhance early intervention strategies and inform clinical practices and public health policies in Nepal and similar settings.
