TOPLINE:

Among infants born near term to term, early-onset neonatal infection (EONI), particularly sepsis and meningitis, was associated with a higher risk for intellectual disability and special educational needs; early-onset meningitis was linked to a markedly higher risk for cognitive impairment than early-onset sepsis.

METHODOLOGY:

• Researchers conducted a nationwide cohort study to evaluate whether EONI among infants born near term to term is linked to long‑term cognitive impairment, particularly intellectual disability and the need for special educational support.
• EONI was defined as sepsis or meningitis occurring within the first week after birth and included both probable cases (a physician-assigned diagnosis of infection using standardised disease codes) and culture-positive cases (a pathogen cultured from the blood or cerebrospinal fluid).
• Data from linked national registries, including a medical birth register in Denmark, were used. The analysis included 993,362 liveborn infants born near term to term between 1997 and 2013, with follow-up until 2021.
• Outcomes were intellectual disability and special educational needs. Intellectual ability was defined using standardised codes. Special educational needs were defined as provision received in either a regular or special education class with at least 9 hours per week on average.

TAKEAWAY:

• Overall, 8267 infants had early-onset sepsis and 149 had early-onset meningitis; of these, 260 had culture-positive sepsis and 31 had culture-positive meningitis.
• Early-onset sepsis was associated with a higher risk for intellectual disability (adjusted hazard ratio [aHR], 2.24; 95% CI, 1.93-2.60) and an increased risk for special educational needs (aHR, 1.49; 95% CI, 1.40-1.59).
• Infants with early-onset meningitis had an approximately eightfold higher risk for intellectual disability and a nearly threefold higher risk for special educational needs.
• Higher risks for intellectual disability and special educational needs were observed in the full cohort (probable plus culture-positive EONI), and similar outcomes were observed in culture-positive EONI alone.

IN PRACTICE:

"EONI in near-term to term children, defined by both probable and culture-positive infections, was associated with an increased risk of intellectual disability and special educational needs. Early-onset meningitis was less frequent than sepsis but associated with higher risks," the authors of the study wrote.

SOURCE:

This study was led by Mads Andersen and Gunvor Bak Rohde, Pediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark. It was published online on February 24, 2026, in Archives of Disease in Childhood - Fetal and Neonatal Edition.

LIMITATIONS:

The validity of intellectual disability diagnoses in Danish registers was not investigated in previous studies. The reliance on probable EONI diagnoses may have included children without actual infection due to non-specific clinical presentation. Despite including several potential confounding variables in adjusted analyses, the researchers acknowledged that they were unable to exclude residual confounding.

DISCLOSURES:

This study was funded by the Graduate School of Health at Aarhus University, Elsass Foundation, Helsefonden, and Beckett Foundation. One author reported having financial ties with MinervaX ApS outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.