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We aimed to investigate whether preterm infants with systemic inflammation would have impaired neurodevelopment and which biomarkers and neurophysiologic studies during inflammation are associated with poor neurodevelopment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This prospective cohort study enrolled infants born before 30\u2009weeks of gestation or with birth weight\u2009&lt;\u20091250\u2009g. Infants were grouped according to the presence of systemic inflammation: Control (no inflammation, <jats:italic>n<\/jats:italic>\u2009=\u200949), I (systemic inflammation, <jats:italic>n<\/jats:italic>\u2009=\u200945). Blood and cerebrospinal fluid samples for markers of brain injury and inflammation were collected and amplitude-integrated electroencephalography (aEEG) was performed within 4 h of septic workup. We evaluated aEEG at 35\u2009weeks postmenstrual age (PMA), head circumference at 36\u2009weeks PMA, and brain MRI at discharge. The Bayley Scales of Infant and Toddler Development III (Bayley-III) was performed at a corrected age (CA) of 18\u2009months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The I group had more white matter injuries (2 vs. 26.7%, Control vs. I, respectively) at the time of discharge, lower brain functional maturation (9.5 vs. 8), and smaller head size (z-score\u2009\u2212\u20091.45 vs. -2.12) at near-term age and poorer neurodevelopment at a CA of 18\u2009months than the control (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Among the I group, the proportion of immature neutrophils (I\/T ratios) and IL-1 beta levels in the CSF were associated with aEEG measures at the day of symptom onset (D0). Seizure spike on aEEG at D0 was significantly correlated with motor and social-emotional domains of Bayley-III (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The I\/T ratio and CRP and TNF-\u03b1 levels of blood at D0, white matter injury on MRI at discharge, head circumference and seizure spikes on aEEG at near-term age were associated with Bayley-III scores at a CA of 18\u2009months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Systemic inflammation induced by clinical infection and NEC are associated with neurodevelopmental impairment in preterm infants. The seizure spike on aEEG, elevated I\/T ratio, CRP, and plasma TNF-alpha during inflammatory episodes are associated with poor neurodevelopment.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12887-021-02583-6","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T05:03:08Z","timestamp":1615179788000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Factors associated with neurodevelopment in preterm infants with systematic inflammation"],"prefix":"10.1186","volume":"21","author":[{"given":"Eun Sun","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ee-Kyung","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung han","family":"Shin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young-Hun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young Hwa","family":"Jung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sae Yun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Won","family":"Koh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eui Kyung","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Eun","family":"Cheon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Suk","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,8]]},"reference":[{"issue":"1","key":"2583_CR1","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1056\/NEJMoa041367","volume":"352","author":"N Marlow","year":"2005","unstructured":"Marlow N, Wolke D, Bracewell MA, Samara M. 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