Neonatal Listeriosis linked to prematurity and adverse neurological outcomes in children

In a groundbreaking study, researchers have delved into the long-term consequences of neonatal listeriosis, a rare yet serious infection that poses a potential threat to maternal and infant health. The study within the French MONALISA cohort provides crucial insights into the neurological and neurodevelopmental outcomes of children who survived this challenging condition. The study underscores the persistent burden of disability among children born with neonatal listeriosis, with prematurity playing a dominant role in long-term outcomes. 

The study results were published in The Lancet - Child & Adolescent Health journal. 

Maternal–neonatal listeriosis, a rare yet serious infection, has prompted a rigorous investigation into the long-term neurological and neurodevelopmental outcomes of surviving infants. It is a rare and severe food infection, that can cause maternal fever, premature delivery, fetal loss, and neonatal systemic and central nervous system infections. Hence, researchers conducted a prospective, matched, observational cohort study within the French MONALISA cohort, to shed light on the lasting impact of neonatal listeriosis on children.

The comprehensive study involved a cohort of 59 surviving infants, all eligible for participation. These children, born with microbiologically confirmed maternal–neonatal listeriosis, underwent meticulous assessments at the age of 5. The evaluations covered a spectrum of parameters, including sensory deficits, executive function, adaptive behavior, and cognitive and motor coordination function. The findings were then meticulously compared with gestational age-matched children from two prominent national prospective cohorts: EPIPAGE-2 (for preterm infants) and ELFE (for term infants from a general population of infants >32 weeks gestation).

Assessments included the French version of the Wechsler Preschool and Primary Scale of Intelligence, fourth edition, and physical examinations to screen for cerebral palsy and developmental coordination disorder. The findings were compared with gestational age-matched children from two national prospective cohorts: EPIPAGE-2 (preterm infants) and ELFE (term infants from a general population of infants >32 weeks gestation).

Findings: 

• Of the 59 eligible children, 53 (median age 5 years) participated in the study between October 26, 2016, and October 29, 2019.
• Notably, 58% were born preterm, and various categories of neonatal listeriosis were represented, including early-onset systemic and non-systemic infection, as well as late-onset systemic infection with meningitis.
• Among the 44 children with available neurodevelopmental disabilities scores, 66% developed at least one disability, and 18% exhibited severe neurodevelopmental disabilities.
• Children with late-onset infection also experienced neurodevelopmental disabilities.
• The neurological and neurodevelopmental outcomes of children with neonatal listeriosis did not differ significantly from gestational age-matched control children without infection.
• The relative risk (RR) of at least one disability was 0.99 (95% CI 0.65–1.51; p=0.97), and the RR of Full Scale Intelligence Quotient (FSIQ) less than –1 standard deviation was 0.92 (0.54–1.54; p=0.74). 

These groundbreaking findings underscore the persistent burden of disability among children born with neonatal listeriosis. With prematurity emerging as a dominant factor in long-term outcomes, the study advocates for the implementation of systematic, long-term screening and the provision of tailored education and special needs support. The insights gained from this comprehensive investigation are poised to shape future approaches to the care and support of individuals impacted by neonatal listeriosis, offering hope for improved outcomes and enhanced quality of life.

Further reading: Long-term neurological and neurodevelopmental outcome of neonatal listeriosis in France: a prospective, matched, observational cohort study. https://doi.org/10.1016/S2352-4642(23)00195-5