Association of Abnormal Cerebral Perfusion in Very Preterm Infants With Late-Onset Sepsis and Neurodevelopmental Outcomes at 2 Years of Age: A Prospective Cohort Study Using Arterial Spin Labeling
In brief
Late-onset sepsis was linked to lower blood flow in seven brain regions
In this prospective cohort of 56 very preterm infants, the 20 who developed late-onset sepsis had lower blood flow in seven brain regions and more communication and personal-social difficulties at age 2. The relationship between perfusion and personal-social scores differed by sepsis status, but the small observational study cannot show that altered blood flow caused developmental differences.
- Journal
- Pediatric neurology (Q1)
- Published
- 22 September 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Hao Song, Huiying Fan, Chen Zhang, Wenli Duan, Yaxuan Liu, Anran Liang, et al.
- PMID
- 42874132
- DOI
- 10.1016/j.pediatrneurol.2026.09.011
Why clinicians should know about it
- Picked for Neonatology (paper of the day, 19 October 2026): LOS associated with lower regional CBF
Abstract
BACKGROUND: To assess cerebral blood flow (CBF) changes in very preterm infants with late-onset sepsis (LOS) using arterial spin labeling and their association with 2 years' corrected-age neurodevelopment. METHODS: Fifty-six infants born at <32 weeks' gestation (LOS, n = 20; non-LOS, n = 36) underwent arterial spin labeling magnetic resonance imaging before discharge and Ages & Stages Questionnaires, Third Edition assessment at 2 years' corrected age. Voxel-wise CBF comparisons used family-wise error correction. Principal component analysis summarized regional CBF, and adjusted interaction models with simple-slope analyses evaluated CBF-development associations. RESULTS: LOS infants exhibited lower CBF in the right superior and inferior orbitofrontal cortex, bilateral olfactory cortex, bilateral gyrus rectus, and left caudate nucleus (PFWE<0.05). Impairments were more prevalent in communication and personal-social domains (P < 0.05). The PC1 × LOS interaction was significant for personal-social scores (β = 7.19, 95% confidence interval 1.58 to 12.80; PFDR = 0.026), but not communication (PFDR = 0.317). The PC1 slope was positive in LOS infants but not statistically significant in non-LOS infants. Only the right gyrus rectus interaction survived regional correction (β = 7.96, 95% confidence interval 2.64-13.28; PFDR = 0.029). CONCLUSIONS: LOS was associated with lower regional CBF, and associations of composite and right gyrus rectus perfusion with personal-social scores differed by LOS status, with positive associations among LOS infants.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.