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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 89-97 |
| Number of pages | 9 |
| Journal | Pediatric Critical Care Medicine |
| Volume | 19 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 1 2018 |
Funding
National Vaccine Program Office at the U.S. Department of Health and Human Services. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Berger’s institution received funding from Eunice Kennedy Shriver National Institute of Child Health and Development and Association for Pediatric Pulmonary Hypertension. He received support for article research from the National Institutes of Health (NIH). Dr. Clark’s institution received funding from the NIH. She received support for article research from the NIH. Dr. Holubkov’s institution received funding from the NIH. He disclosed other support from Data Safety Monitoring Board (DSMB) member for Fibrocell Inc (past), American Burn Association (past), and Armaron Bio (current). He received support for article research from the NIH. He received funding from St. Jude Medical (biostatistical consulting), Pfizer Inc (DSMB), and DURECT Corporation (biostatistical consulting). Dr. Pollack’s institution received funding from the NIH. He received support for article research from the NIH. Dr. Berg’s institution received funding from the National Institute for Child Health and Human Development (NICHD). He received support for article research from the NIH. Dr. Carcillo’s institution received funding from the NICHD. He received support for article research from the NIH. Dr. Dalton’s institution received funding from the NIH. She received funding from Innovative extracorporeal membrane oxygenation Concepts and Maquet. She received support for article research from the NIH. Dr. Harrison’s institution received funding from the NIH. He received support for article research from the NIH. Dr. Meert’s institution received funding from the NIH. She received support for article research from the NIH. Dr. Newth’s institution received funding from the NICHD. He received support for article research from the NIH. Dr. Shanley’s institution received funding from the NIH. He received support for article research from the NIH. He received funding from International Pediatric Research Foundation Dr. Wessel’s institution received funding from the NIH. He received support for article research from the NIH. Dr. Anand received support for article research from the NIH. Dr. Zimmerman’s institution received funding from the NIH and Immunexpress, Seattle (research funding). He received support for article research from the NIH. He received funding from Society of Critical Care Medicine (travel reimbursement to attend board meetings) and from Elsevier Publishing (royalties for coediting the textbook, Pediatric Critical Care). Dr. Sanders Jr received support for article research from the NIH. Dr. Liu’s institution received funding from the NIH/NICHD. She received support for article research from the NIH. Dr. Burr’s institution received funding from the NICHD. He received support for article research from the NIH. Dr. Doctor received support for article research from the NIH. His institution received funding from the NIH, Department of Defense, and Children’s Discovery Institute. Dr. Dean’s institution received funding from the NICHD. He received support for article research from the NIH. Dr. Jenkins disclosed government work: I completed this work as part of official duties as a Federal Employee of the National Institutes of Health. Dr. Nicholson disclosed government work. She received support for article research from the NIH. The remaining authors have disclosed that they do not have any potential conflicts of interest. For information regarding this article, E-mail: [email protected] 1Department of Pediatrics, Children’s National Medical Center, Washing-ton, DC. 2Department of Psychiatry, University of North Carolina at Chapel Hill, Asheville, NC. 3Department of Pediatrics, Univesity of Utah, Salt Lake City, UT. 4Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA. 5Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Pittsburgh, Pittsburgh, PA. 6Department of Child Health, Phoenix Children’s Hospital, Phoenix, AZ. 7Department of Pediatrics, Mattel Children’s Hospital UCLA, Los Ange-les, CA. 8Department of Pediatrics, Children’s Hospital of Michigan, Detroit, MI. 9Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, CA. 10Department of Pediatrics and Communicable Diseases, C.S. Mott Chil-dren’s Hospital, Ann Arbor, MI. 11Department of Pediatrics, Le Bonheur Children’s Hospital, Memphis. TN. 12Department of Pediatrics, Seattle Children’s Hospital, Seattle, WA. 13Department of Pediatrics, Arkansas Children’s Hospital, Little Rock, AR. 14Department of Pediatrics, Virginia Commonwealth University, Richmond, VA. 15Departments of Pediatrics and Biochemistry, St. Louis Children’s Hos-pital, St. Louis, MO. 16Pediatric Trauma and Critical Illness Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. Supported, in part, by cooperative agreements from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services (U10HD05009, U10HD049945, U10HD050096, U10HD049981, U10HD049983, U10HD050012, U10HD063108, U10HD063106, U10HD063114, U01HD049934). Initial support was provided by the
Keywords
- child development
- intensive care
- neurologic complications
- outcome assessment
- pertussis
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Critical Care and Intensive Care Medicine
